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KMID : 0948920120110010001
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Clinical Pain
2012 Volume.11 No. 1 p.1 ~ p.4
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Conservative Management for Rotator Cuff Tears and Calcific Tendinitis
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Chung Sun-Gun
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Abstract
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Rotator cuff tendon tears and calcific tendinitis are common problems affecting middle aged shoulders, resulting in pain and limitation of motion. The afflictions caused by the problems fall in wider ranges - from asymptomatic to sleep disturbing agony. Most of the two problems can be successfully managed conservatively by aiming at minimizing pain and limitation of motion and improving underlying biomechanics. Pain relief and increase of motion can be effectively achieved by steroid injection under accurate image guidance. For a significantly big calcium nodule that causes strenuous pain, calcium barbotage, which is washing out calcium material using a large diameter needle (mostly larger than 18 gauge) and saline loaded syringe. After successful pain relief and increase of range of motion, passive stretch can further help to improve in range of motion. Restoration of healthy biomechanics should be done focusing on scapular range of motion and stabilization, which is the most important part in conservative treatment to ameliorate pain and disability and to maximize functional capacity in long-term perspectives. It is important to note that failure of a type of conservative treatment is usually resulted from a wrong diagnosis. Integrating history and physical examination findings with image diagnosis is crucial to make a right decision whether and how a lesion should be treated.
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KEYWORD
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Rotator cuff tendon tears, Calcific tendinitis, Shoulder, Treatment, Barbotage
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