Symptoms:

TENDINITIS OR IMPINGEMENT SYNDROME

Early on, pain occurs with overhead activities and lifting your arm to the side. Activities include brushing hair, reaching for objects on shelves, or playing an overhead sport.

• Pain is more likely in the front of the shoulder and may radiate to the side of the arm. However, this pain always stops before the elbow. If the pain travels beyond the arm to the elbow and hand, this may indicate a pinched nerve.
• There may also be pain with lowering the shoulder from a raised position.

At first, this pay may be mild and occur only with certain movements of the arm. Over time, pain may be present at rest or at night, especially when lying on the affected shoulder.

You may have weakness and loss of motion when raising the arm above your head. Your shoulder can feel stiff with lifting or movement. It may become more difficult to place the arm behind your back.

ROTATOR CUFF TEARS

The pain with a sudden tear after a fall or injury is usually intense. Weakness of the shoulder and arm is often present, along with a snapping sensation of movement.

Symptoms of a chronic rotator cuff tear include a gradual worsening of pain, weakness, and stiffness or loss of motion. The exact point when a rotator cuff tear begins in someone with chronic shoulder tendinitis may or may not be noticed.

Most people with rotator cuff tendon tears have pain at night. Pain that is worse at night may wake you up. During the day, the pain is more tolerable and hurts with certain movements.

Over time, the symptoms become much worse and are not relived by medicines, rest, or exercise.

Signs and tests:

A physical examination may reveal tenderness over the shoulder. Pain may occur when the shoulder is raised overhead. There is usually weakness of the shoulder when it is placed in certain positions.

X-rays of the shoulder may show a bone spur. They can be done in your doctor's office.

If your doctor feels you may have a rotator cuff tear, you may have one or more of the following tests:

• An ultrasound test uses sound waves to create an image of the shoulder joint. It can often show a tear in the rotator cuff.
• MRI of the shoulder may show swelling or a tear in the rotator cuff.

Sometimes, a special imaging test called arthrography is needed to diagnose a rotator cuff tear. Your doctor will inject contrast material into your shoulder joint. Then either an x-ray, CT scan, or MRI scan are used to take a picture of it. Contrast is usually used when your doctor suspects a small rotator cuff tear.