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Content Map Terms
Illnesses & Conditions Categories
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Allergies
- Allergy to Natural Rubber (Latex)
- Jellyfish Stings: Allergic Reaction
- Allergies: Should I Take Allergy Shots?
- Non-Allergic Rhinitis
- Allergic Reaction
- Allergies
- Allergy Shots for Allergic Rhinitis
- Allergies: Rush Immunotherapy
- Over-the-Counter Medicines for Allergies
- Allergic Rhinitis
- Types of Allergens
- Allergies: Avoiding Indoor Triggers
- Allergies: Avoiding Outdoor Triggers
- Controlling Dust, Dust Mites, and Other Allergens in Your Home
- Controlling Pet Allergens
- Allergies to Insect Stings
- Allergies: Should I Take Shots for Insect Sting Allergies?
- Immunotherapy for Allergies to Insect Stings
- Types of Allergic Rhinitis
- Allergic Reaction to Tattoo Dye
- Drug Allergies
- Penicillin Allergy
- Hay Fever and Other Seasonal Allergies
- Allergies: Giving Yourself an Epinephrine Shot
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Arthritis and Osteoporosis
- Rheumatoid Arthritis: Finger and Hand Surgeries
- Rheumatoid Arthritis: Classification Criteria
- Rheumatoid Arthritis: Systemic Symptoms
- Comparing Rheumatoid Arthritis and Osteoarthritis
- Rheumatoid Arthritis: Neck Symptoms
- Osteoporosis in Men
- Psoriatic Arthritis
- Arthritis: Shots for Knee Pain
- Complementary Medicine for Arthritis
- Steve's Story: Coping With Arthritis
- Bev's Story: Coping With Arthritis
- Quick Tips: Modifying Your Home and Work Area When You Have Arthritis
- Coping With Osteoarthritis
- Arthritis: Should I Have Shoulder Replacement Surgery?
- Juvenile Idiopathic Arthritis: Stretching and Strengthening Exercises
- Juvenile Idiopathic Arthritis
- Capsaicin for Osteoarthritis
- Small Joint Surgery for Osteoarthritis
- Osteoarthritis: Heat and Cold Therapy
- Modifying Activities for Osteoarthritis
- Osteoarthritis
- Gout
- Rheumatoid Arthritis
- Juvenile Idiopathic Arthritis: Inflammatory Eye Disease
- Juvenile Idiopathic Arthritis: Range-of-Motion Exercises
- Juvenile Idiopathic Arthritis: Deciding About Total Joint Replacement
- Complications of Osteoarthritis
- Arthritis: Managing Rheumatoid Arthritis
- Arthritis: Should I Have Knee Replacement Surgery?
- Arthritis: Should I Have Hip Replacement Surgery?
- Juvenile Idiopathic Arthritis: Pain Management
- Osteoporosis Risk in Younger Women
- Osteoporosis Screening
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Asthma
- Asthma: Peak Expiratory Flow and Personal Best
- Asthma and Wheezing
- Asthma: Using an Asthma Action Plan
- Asthma: Measuring Peak Flow
- Asthma: Identifying Your Triggers
- Steroid Medicine for Asthma: Myths and Facts
- Asthma
- Inhaled corticosteroids for asthma
- Inhaled quick-relief medicines for asthma
- Classification of Asthma
- Challenge Tests for Asthma
- Asthma's Impact on Your Child's Life
- Asthma Action Plan: Yellow Zone
- Asthma Triggers
- Asthma Action Plan: Red Zone
- Asthma and GERD
- Occupational Asthma
- Asthma Attack
- Asthma: Symptoms of Difficulty Breathing
- Exercise-Induced Asthma
- Asthma Treatment Goals
- Asthma: Overcoming Obstacles to Taking Medicines
- Asthma in Older Adults: Managing Treatment
- Asthma: Controlling Cockroaches
- Asthma: Educating Yourself and Your Child
- Allergy Shots for Asthma
- Asthma: Taking Charge of Your Asthma
- Monitoring Asthma Treatment
- Omalizumab for Asthma
- Asthma: Ways to Take Inhaled Medicines
- Asthma: Overuse of Quick-Relief Medicines
- Asthma Diary
- Asthma Diary Template
- Asthma Action Plan
- Assessing Your Asthma Knowledge
- My Asthma Action Plan
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Bowel and Gastrointestinal Conditions
- Abdominal Fullness or Bloating
- Irritable Bowel Syndrome: Criteria for Diagnosis
- Gastritis
- Gas, Bloating, and Burping
- Irritable Bowel Syndrome (IBS)
- Constipation: Keeping Your Bowels Healthy
- Rectal Problems
- Mild, Moderate, or Severe Diarrhea
- Torn or Detached Nail
- Chronic Constipation
- Gas (Flatus)
- Dyspepsia
- Diverticulosis
- Bowel Obstruction
- Anal Fissure
- Bowel Disease: Caring for Your Ostomy
- Anal Fistulas and Crohn's Disease
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Cancer
- Lung Cancer and Other Lung Problems From Smoking
- Skin Cancer, Non-Melanoma
- Radiation Therapy for Non-Melanoma Skin Cancer
- Colorectal Cancer Test Recommendations
- Breast Cancer Screening: When Should I Start Having Mammograms?
- Lifestyle Changes That May Help Prevent Cancer
- Choosing a Prosthesis After Breast Cancer Surgery
- Hormone Treatment for Breast Cancer
- Cancer Staging and Grading
- Pancreatic Cancer
- Kidney (Renal Cell) Cancer
- Cancer Support: Managing Stress
- Cancer Support: When Your Cancer Comes Back or Gets Worse
- Cancer Support: Dealing With Emotions and Fears
- Cancer Support: Finding Out That You Have Cancer
- Cancer Support: Being an Active Patient
- Cancer Support: Coping With Cancer Treatments
- Cancer Support: Life After Treatment
- Cancer Support: Family, Friends, and Relationships
- Reducing Cancer Risk When You Are BRCA-Positive
- Anal Cancer
- Prostate Cancer: Should I Choose Active Surveillance?
- Lung Cancer Screening
- Basal Cell Skin Cancer: Should I Have Surgery or Use Medicated Cream?
- Tumour Markers
- Does Aspirin Prevent Cancer?
- Cancer
- Lung Cancer
- Oral Cancer
- Colorectal Cancer
- Metastatic Melanoma
- Radiation Treatment for Cancer
- Skin Cancer, Melanoma
- Cervical Cancer Screening
- Hepatitis B and C: Risk of Liver Cancer
- Inflammatory Bowel Disease and Cancer Risk
- Radiation Therapy for Prostate Cancer
- Prostate Cancer
- Cancer: Home Treatment for Mouth Sores
- Skin Cancer Screening
- Breast Cancer: Should I Have Breast Reconstruction After a Mastectomy?
- Prostate Cancer: Should I Have Radiation or Surgery for Localized Prostate Cancer?
- Prostate Cancer Screening
- Side Effects of Chemotherapy
- Breast Cancer: Lymph Node Surgery for Staging Cancer
- Endometrial (Uterine) Cancer
- Cryosurgery for Prostate Cancer
- Breast Cancer
- Cancer: Home Treatment for Nausea or Vomiting
- Cancer: Home Treatment for Pain
- Cancer: Home Treatment for Diarrhea
- Cancer: Home Treatment for Constipation
- Breast Cancer Types
- Cancer: Home Treatment for Sleep Problems
- Cancer: Home Treatment for Fatigue
- Hair Loss From Cancer Treatment
- Body Image After Cancer Treatment
- Breast Cancer: Should I Have Breast-Conserving Surgery or a Mastectomy for Early-Stage Cancer?
- Breast Cancer, Metastatic or Recurrent
- Cancer Pain
- Leukemia
- Colorectal Cancer, Metastatic or Recurrent
- Thyroid Cancer
- Types of Thyroid Cancer
- Radiation Therapy for Cancer Pain
- Breast Cancer in Men (Male Breast Cancer)
- Breast Cancer Screening
- Breast Cancer: Should I Have Chemotherapy for Early-Stage Breast Cancer?
- Asbestos and Lung Cancer
- Cervical Cancer
- Ovarian Cancer
- Colon Cancer Genetic Testing
- Testicular Cancer Screening
- Skin Cancer: Protecting Your Skin
- Non-Melanoma Skin Cancer: Comparing Treatments
- Bladder Cancer
- Prostate Cancer, Advanced or Metastatic
- Active Surveillance for Prostate Cancer
- Urinary Problems and Prostate Cancer
- Cancer: Controlling Cancer Pain
- Heat and Cold Treatment for Cancer Pain
- Testicular Cancer
- Testicular Cancer: Which Treatment Should I Have for Stage I Non-Seminoma Testicular Cancer After My Surgery?
- Testicular Cancer: Which Treatment Should I Have for Stage I Seminoma Testicular Cancer After My Surgery?
- Cancer: Controlling Nausea and Vomiting From Chemotherapy
- Lymphedema: Managing Lymphedema
- Breast Cancer Risk: Should I Have a BRCA Gene Test?
- Inflammatory Breast Cancer
- Ovarian Cancer: Should I Have My Ovaries Removed to Prevent Ovarian Cancer?
- Family History and the Risk for Breast or Ovarian Cancer
- Breast Cancer: What Should I Do if I'm at High Risk?
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Cold and Flu
- Difference Between Influenza (Flu) and a Cold
- Colds and Flu
- Influenza (Flu) Complications
- Flu Vaccine Myths
- Influenza (Seasonal Flu)
- Whooping Cough (Pertussis)
- Productive Coughs
- Dry Coughs
- Influenza (Flu): Should I Take Antiviral Medicine?
- Flu Vaccines: Should I Get a Flu Vaccine?
- Relieving A Cough
- Colds
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COPD
- Cal's Story: Learning to Exercise When You have COPD
- Conserving Energy When You Have COPD or Other Chronic Conditions
- Nebulizer for COPD Treatment
- COPD Action Plan
- COPD: Help for Caregivers
- COPD: Keeping Your Diet Healthy
- COPD: Using Exercise to Feel Better
- COPD
- COPD Flare-Ups
- Bullectomy for COPD
- COPD and Alpha-1 Antitrypsin (AAT) Deficiency
- COPD and Sex
- Pulmonary Rehabilitation for Chronic Obstructive Pulmonary Disease (COPD)
- COPD
- Oxygen Treatment for Chronic Obstructive Pulmonary Disease (COPD)
- COPD: Avoiding Weight Loss
- COPD: Avoiding Your Triggers
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Dementia
- Alzheimer's or Other Dementia: Should I Move My Relative Into Long-Term Care?
- Alzheimer's and Other Dementias: Coping With Sundowning
- Dementia: Assessing Pain
- Medical History and Physical Examination for Dementia or Alzheimer's Disease
- Alzheimer's and Other Dementias: Making the Most of Remaining Abilities
- Dementia: Helping a Person Avoid Confusion
- Alzheimer's and Other Dementias: Maintaining Good Nutrition
- Dementia: Tips for Communicating
- Agitation and Dementia
- Dementia: Bladder and Bowel Problems
- Dementia: Support for Caregivers
- Dementia: Legal Issues
- Dementia: Understanding Behaviour Changes
- Dementia: Medicines to Treat Behaviour Changes
- Dementia
- Mild Cognitive Impairment and Dementia
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Diabetes
- Diabetes: Blood Sugar Levels
- Diabetes: Counting Carbs if You Don't Use Insulin
- Diabetes: Coping With Your Feelings About Your Diet
- Diabetes: Tracking My Feelings
- Diabetes: Taking Care of Your Feet
- Diabetes: Care of Blood Sugar Test Supplies
- Diabetes: Checking Your Blood Sugar
- Diabetes: Checking Your Feet
- Diabetes: Steps for Foot-Washing
- Diabetes: Protecting Your Feet
- Diabetes: Dealing With Low Blood Sugar From Medicines
- Diabetes: Dealing With Low Blood Sugar From Insulin
- Diabetes: How to Give Glucagon
- Low Blood Sugar Level Record
- Symptoms of Low Blood Sugar
- Diabetes: Preventing High Blood Sugar Emergencies
- Diabetic Ketoacidosis (DKA)
- High Blood Sugar Level Record
- Symptoms of High Blood Sugar
- Diabetes: Using a Plate Format to Plan Meals
- Diabetes: Giving Yourself an Insulin Shot
- Diabetes: Eating Low-Glycemic Foods
- Diabetes and Alcohol
- Continuous Glucose Monitoring
- Quick Tips: Diabetes and Shift Work
- Diabetes: How to Prepare for a Colonoscopy
- Type 2 Diabetes: Can You Cure It?
- Diabetes, Type 2: Should I Take Insulin?
- Prediabetes: Which Treatment Should I Use to Prevent Type 2 Diabetes?
- Diabetes: Making Medical Decisions as Your Health Changes
- Diabetes Care Plan
- Diabetes: Caregiving for an Older Adult
- Quick Tips: Smart Snacking When You Have Diabetes
- Testing Tips From a Diabetes Educator
- Gloria's Story: Adding Activity to Help Control Blood Sugar
- Andy's Story: Finding Your Own Routine When You Have Diabetes
- Jerry's Story: Take Prediabetes Seriously
- Linda's Story: Getting Active When You Have Prediabetes
- Diabetes
- Tips for Exercising Safely When You Have Diabetes
- Diabetes: Travel Tips
- Type 2 Diabetes
- Type 1 Diabetes
- Care of Your Skin When You Have Diabetes
- Care of Your Teeth and Gums When You Have Diabetes
- Non-insulin medicines for type 2 diabetes
- Metformin for diabetes
- Hypoglycemia (Low Blood Sugar) in People Without Diabetes
- Diabetic Retinopathy
- Laser Photocoagulation for Diabetic Retinopathy
- Diabetic Neuropathy
- Diabetic Focal Neuropathy
- Diabetic Neuropathy: Exercising Safely
- Diabetic Autonomic Neuropathy
- Criteria for Diagnosing Diabetes
- Diabetes-Related High and Low Blood Sugar Levels
- Diabetic Nephropathy
- Diabetes: Counting Carbs if You Use Insulin
- Diabetes: Cholesterol Levels
- Diabetes and Infections
- Diabetes: Tests to Watch for Complications
- Diabetes: Differences Between Type 1 and 2
- Diabetes Complications
- How Diabetes Causes Blindness
- How Diabetes Causes Foot Problems
- Reading Food Labels When You Have Diabetes
- Eating Out When You Have Diabetes
- Breastfeeding When You Have Diabetes
- Diabetes: Staying Motivated
- Sick-Day Guidelines for People With Diabetes
- Diabetes: Amputation for Foot Problems
- Prediabetes
- Prediabetes: Exercise Tips
- Type 2 Diabetes: Screening for Adults
- Diabetes: Should I Get an Insulin Pump?
- Diabetes: Living With an Insulin Pump
- Form for Carbohydrate Counting
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Disease and Disease Prevention
- Diseases and Conditions
- Osgood-Schlatter Disease
- Needle Aponeurotomy for Dupuytren's Disease
- Mitochondrial Diseases
- Disease and Injury Prevention
- Alzheimer's Disease
- Root Planing and Scaling for Gum Disease
- Kawasaki Disease
- Tay-Sachs Disease
- Von Willebrand's Disease
- Hirschsprung's Disease
- Complications of Paget's Disease
- Paget's Disease of Bone
- Celiac Disease
- Peptic Ulcer Disease
- Ménière's Disease
- Pelvic Inflammatory Disease: Tubo-Ovarian Abscess
- Pelvic Inflammatory Disease
- Addison's Disease
- Misdiagnosis of Lyme Disease
- Lyme Disease
- Parkinson's Disease and Freezing
- Parkinson's Disease: Other Symptoms
- Parkinson's Disease: Modifying Your Activities and Your Home
- Parkinson's Disease and Tremors
- Parkinson's Disease and Speech Problems
- Parkinson's Disease
- Disease-modifying antirheumatic drugs (DMARDs)
- Parkinson's Disease: Movement Problems From Levodopa
- Mad Cow Disease
- Handwashing
- Peyronie's Disease
- Stages of Lyme Disease
- Osteotomy and Paget's Disease
- Dupuytren's Disease
- Crohn's Disease
- Crohn's Disease: Problems Outside the Digestive Tract
- Pilonidal Disease
- Acquired Von Willebrand's Disease
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Down Syndrome, Autism and Developmental Delays
- Autism
- Down Syndrome: Helping Your Child Eat Independently
- Down Syndrome: Grooming and Hygiene
- Down Syndrome: Helping Your Child Learn to Walk and Use Other Motor Skills
- Down Syndrome: Helping Your Child Learn to Communicate
- Down Syndrome
- Dyslexia
- Conditions Related to Dyslexia
- Autism: Behavioural Training and Management
- Autism: Support and Training for the Family
- Unproven Treatments for Autism
- Caring for Adults With Autism
- Down Syndrome: Helping Your Child Avoid Social Problems
- Down Syndrome: Training and Therapy for Young People
- Down Syndrome: Helping Your Child Dress Independently
- Down Syndrome, Ages Birth to 1 Month
- Down Syndrome, Ages 1 Month to 1 Year
- Down Syndrome, Ages 1 to 5
- Down Syndrome, Ages 5 to 13
- Down Syndrome, Ages 13 to 21
- Eating Disorders
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Epilepsy
- Absence Epilepsy
- Juvenile Myoclonic Epilepsy
- Temporal Lobe Epilepsy
- Focal Epilepsy
- Epilepsy: Simple Partial Seizures
- Epilepsy
- Epilepsy and Driving
- Epilepsy: Generalized Seizures
- Epilepsy: Generalized Tonic-Clonic Seizures
- Epilepsy: Myoclonic Seizures
- Epilepsy: Atonic Seizures
- Epilepsy: Tonic Seizures
- Epilepsy: Complex Partial Seizures
- Epilepsy Medicine Therapy Failure
- Stopping Medicine for Epilepsy
- Questions About Medicines for Epilepsy
- Epilepsy: Taking Your Medicines Properly
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Fatigue and Sleep
- Sleep Apnea: Should I Have a Sleep Study?
- Sleep and Your Health
- Quick Tips: Making the Best of Shift Work
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Managing Your Energy
- Sleeping Better
- Sleep Problems
- Doxepin (Sleep) - Oral
- Improving Sleep When You Have Chronic Pain
- Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
- Chronic Fatigue: Changing Your Schedule
- Chronic Fatigue: Getting Support
- Snoring and Obstructive Sleep Apnea
- Coping With Changing Sleep Patterns as You Get Older
- Stages of Sleep
- Sleep Apnea: Fibre-Optic Pharyngoscopy
- Sleep Apnea: Oral Devices
- Continuous Positive Airway Pressure (CPAP) Therapy for Obstructive Sleep Apnea
- Sleep Apnea
- Sleep Problems, Age 12 and Older
- Stages of Sleep Apnea
- Sleep Journal
- Shift Work Sleep Disorder
- Snoring
- Sleep Problems: Dealing With Jet Lag
- Insomnia
- Sleep and Your Body Clock
- Weakness and Fatigue
- Insomnia: Improving Your Sleep
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Heart Health and Stroke
- Peripheral Arterial Disease of the Legs
- Bradycardia (Slow Heart Rate)
- Types of Bradycardia
- Cardiac Device Monitoring
- Angioplasty for Peripheral Arterial Disease of the Legs
- Isolated Systolic High Blood Pressure
- Atrial Fibrillation: Should I Try Electrical Cardioversion?
- Change in Heartbeat
- Deep Vein Thrombosis
- Fast Heart Rate
- Heart Failure: Symptom Record
- Heart Failure: Compensation by the Heart and Body
- Heart Failure: Taking Medicines Properly
- Heart Failure: Watching Your Fluids
- Heart Failure: Avoiding Triggers for Sudden Heart Failure
- Heart Failure: Activity and Exercise
- Heart Tests: When Do You Need Them?
- Low Blood Pressure (Hypotension)
- Cardiac Arrest
- Heart Failure Daily Action Plan
- Premature Ventricular Contractions (PVCs)
- Heart Rate Problems: Should I Get a Pacemaker?
- Heart Rhythm Problems: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- What to Do if Your Cardiac Device Is Recalled
- Venous Insufficiency
- Carotid Artery Stenting
- ICD: Living Well With It
- Diabetes: Lower Your Risk for Heart Attack and Stroke
- Pacemaker for Heart Failure (Cardiac Resynchronization Therapy)
- Heart Attack: How to Prevent Another One
- Stroke: How to Prevent Another One
- Sex and Your Heart
- Supraventricular Tachycardia: Should I Have Catheter Ablation?
- Carotid Artery Disease
- Giant Cell Arteritis
- High Blood Pressure: Over-the-Counter Medicines to Avoid
- Postural Orthostatic Tachycardia Syndrome (POTS)
- Leg Aneurysm
- Pulmonary Hypertension
- Left Ventricular Hypertrophy (LVH)
- Heart Failure: Checking Your Weight
- Alan's Story: Coping With Change After a Heart Attack
- Coronary Artery Disease: Prevention Myths
- Quick Tips: Taking Charge of Your Angina
- Heart and Circulation
- High Blood Pressure
- Heartburn
- Angioplasty for Coronary Artery Disease
- Coronary Artery Disease
- Implantable Cardioverter-Defibrillator (ICD)
- Aortic Valve Regurgitation
- Aortic Valve Stenosis
- Secondary High Blood Pressure
- Hemorrhagic Stroke
- Stroke: Common Disabilities
- Self-Care After a Stroke
- Stroke: Dealing With Depression
- Stroke: Getting Dressed
- Stroke: Speech and Language Problems
- Stroke: Bladder and Bowel Problems
- Stroke: Preventing Injury in Affected Limbs
- After a Stroke: Helping Your Family Adjust
- Stroke: Behaviour Changes
- Stroke: Changes in Emotions
- Stroke: Perception Changes
- Stroke: Problems With Ignoring the Affected Side
- Stroke: Memory Tips
- Stroke: Your Rehabilitation Team
- Stroke
- Transient Ischemic Attack (TIA)
- Cardiac Rehabilitation: Lifestyle Changes
- Cardiac Rehabilitation: Hospital Program
- Cardiac Rehabilitation: Home Program
- Cardiac Rehabilitation: Outpatient Program
- Cardiac Rehabilitation: Maintenance Program
- Congenital Heart Defects
- Congenital Heart Defects: Caring for Your Child
- Coronary Artery Disease: Should I Have an Angiogram?
- Triggers of Sudden Heart Failure
- Classification of Heart Failure
- Heart Failure: Tips for Easier Breathing
- Heart Failure: Avoiding Colds and Flu
- Heart Failure
- Helping Someone During a Panic Attack
- Aortic Aneurysm
- High Blood Pressure
- Coronary Artery Disease: Family History
- Angina
- Using Nitroglycerin for Angina
- Heartburn: Changing Your Eating Habits
- Angiotensin II receptor blockers (ARBs)
- Beta-blockers
- Heart Rhythm Problems: Diary of Symptoms
- Vagal Manoeuvres for Supraventricular Tachycardia (SVT)
- Electrical Cardioversion (Defibrillation) for a Fast Heart Rate
- Catheter Ablation for a Fast Heart Rate
- Supraventricular Tachycardia
- Home Blood Pressure Log
- Blood Pressure Screening
- Heart Block
- Electrical System of the Heart
- Heart Rhythm Problems and Driving
- Heart Rhythm Problems: Symptoms
- Resuming Sexual Activity After a Heart Attack
- Risk Factors for Coronary Artery Disease
- Pacemaker for Bradycardia
- SPECT Image of the Heart
- Heart Attack and Stroke in Women: Reducing Your Risk
- Ventricular Tachycardia
- Aspirin to Prevent Heart Attack and Stroke
- Temporal Artery Biopsy
- Emergency First Aid for Heatstroke
- Heartburn Symptom Record
- Heart Attack and Unstable Angina
- Congenital Heart Defects in Adults
- Monitoring and Medicines for Heart Failure
- Ventricular Assist Device (VAD) for Heart Failure
- Cardiac Output
- Heart Failure Symptoms
- Heart Failure: Less Common Symptoms
- Heart Failure With Reduced Ejection Fraction (Systolic Heart Failure)
- Heart Failure With Preserved Ejection Fraction (Diastolic Heart Failure)
- High-Output Heart Failure
- Right-Sided Heart Failure
- Heart Failure Complications
- How the Heart Works
- Coronary Arteries and Heart Function
- Heart Failure Types
- Enjoying Life When You Have Heart Failure
- Heart Failure: Tips for Caregivers
- Medicines to Prevent Abnormal Heart Rhythm in Heart Failure
- Cardiac Cachexia
- Heart Failure Stages
- Cardiac Rehabilitation Team
- Cardiac Rehabilitation: Emotional Health Benefits
- Ischemia
- Coronary Artery Disease: Roles of Different Doctors
- Coronary Artery Disease: Helping a Loved One
- Manage Stress for Your Heart
- Intermittent Claudication
- Peripheral Arterial Disease: Pulse and Blood Pressure Measurement
- Heart Failure and Sexual Activity
- Joan's Story: Coping With Depression and Anxiety From Heart Failure
- Rheumatic Fever and the Heart
- Heart Valve Problems: Should I Choose a Mechanical Valve or Tissue Valve to Replace My Heart Valve?
- Acute Coronary Syndrome
- Aspirin: Should I Take Daily Aspirin to Prevent a Heart Attack or Stroke?
- Heart Failure: Should I Get a Pacemaker ?
- Heart Failure: Should I Get an Implantable Cardioverter-Defibrillator (ICD)?
- Heart Valve Disease
- Myxoma Tumours of the Heart
- Aortic Dissection
- Heart Attack and Stroke Risk Screening
- High Blood Pressure: Checking Your Blood Pressure at Home
- Hypertensive Emergency
- Stroke Rehabilitation
- Treatment for Stroke-Related Spasticity
- Driving a Car After a Stroke
- Heart Failure: Avoiding Medicines That Make Symptoms Worse
- Stroke Recovery: Coping With Eating Problems
- Heart Murmur
- High Blood Pressure: Should I Take Medicine?
- Coronary Artery Disease: Should I Have Angioplasty for Stable Angina?
- Tyrell's Story: Taking Pills for High Blood Pressure
- Stroke Prevention: Should I Have a Carotid Artery Procedure?
- Atrial Fibrillation: Which Anticoagulant Should I Take to Prevent Stroke?
- Stroke: Should I Move My Loved One Into Long-Term Care?
- Atrial Fibrillation: Should I Take an Anticoagulant to Prevent Stroke?
- Smoking and Coronary Artery Disease
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Hepatitis
- Hepatitis C: Your Risk for Cirrhosis
- Hepatitis E
- Hepatitis B Immune Globulin - Injection
- Heparin - Injection
- Fulminant Hepatitis
- Protect Yourself From Hepatitis A When Travelling
- Hepatitis A
- Viral Hepatitis
- Hepatitis C
- Hepatitis D
- Hepatitis B: How to Avoid Spreading the Virus
- Hepatitis B
- Hepatitis Panel
- Hepatitis B Treatment Recommendations
- Hepatitis B: Should I Be Tested?
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HIV
- HIV Infection
- HIV Viral Load
- HIV: Stages of Infection
- Ways HIV Cannot Be Spread
- HIV and Exercise
- HIV: Giving Support
- HIV: Tips for Caregivers to Avoid Infection
- HIV: Preventing Other Infections When You Have HIV
- HIV Home Care
- Antiretroviral medicines for HIV
- Resistance to HIV Medicines
- HIV: Preventing Infections
- HIV: Antiretroviral Therapy (ART)
- Opportunistic Infections in HIV
- HIV: Taking Antiretroviral Drugs
- HIV: Non-Progressors and HIV-Resistant People
- HIV Screening
- HIV and Weight Loss
- HIV and Fatigue
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Infectious Diseases
- Anthrax
- Avian Influenza
- Avoiding Infections in the Hospital
- Bacterial Infections of the Spine
- Bites and Stings: Flu-Like Symptoms
- Boric Acid for Vaginal Yeast Infection
- Caregiving: Reducing Germs and Infection in the Home
- Central Venous Catheter: Flushing
- Chickenpox (Varicella)
- Chickenpox: Preventing Skin Infections
- Chikungunya Fever
- Complicated Urinary Tract Infections
- Complications of Ear Infections
- Cranberry Juice and Urinary Tract Infections
- Dengue Fever
- Ear Infection: Should I Give My Child Antibiotics?
- Ear Infections
- Ebola or Marburg Virus Infection
- Ebola Virus Disease
- Enterovirus D68 (EV-D68)
- Fever or Chills, Age 11 and Younger
- Fever or Chills, Age 12 and Older
- Fever Seizures
- Fever Temperatures: Accuracy and Comparison
- Feverfew for Migraines
- Fifth Disease
- Flu: Signs of Bacterial Infection
- Fungal Nail Infections
- Giardiasis
- Hand-Foot-and-Mouth Disease
- Kissing Bugs
- Measles (Rubeola)
- Middle East Respiratory Syndrome (MERS)
- Molluscum Contagiosum
- Monkeypox
- Mononucleosis (Mono)
- Mononucleosis Complications
- Mumps
- Nail Infection: Should I Take Antifungal Pills?
- Neutropenia: Preventing Infections
- Non-Surgical Nail Removal for Fungal Nail Infections
- Noroviruses
- Pleurisy
- Pneumonia
- Preventing Tetanus Infections
- Pseudomonas Infection
- Recurrent Ear Infections and Persistent Effusion
- Recurrent Vaginal Yeast Infections
- Respiratory Syncytial Virus (RSV) Infection
- Rotavirus
- Rubella (German Measles)
- Scarlet Fever
- Sexually Transmitted Infections
- Sexually Transmitted Infections: Genital Examination for Men
- Sexually Transmitted Infections: Symptoms in Women
- Sexually Transmitted Infections: Treatment
- Shingles
- Smallpox
- Sore Throat and Other Throat Problems
- Staph Infection
- Strep Throat
- Symptoms of Pelvic Infection
- Thrush
- Tick Bites: Flu-Like Symptoms
- Tinea Versicolor
- Tuberculosis (TB)
- Tuberculosis Screening
- Urinary Tract Infections (UTIs) in Older Adults
- Vaginal Yeast Infection: Should I Treat It Myself?
- Vaginal Yeast Infections
- Valley Fever
- West Nile Virus
- Zika Virus
- Informed Health Decisions
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Injuries
- Trapped Finger, Toe, or Limb
- Blister Care
- Exercises for Heel Pain or Tightness
- Broken Toe
- Broken Nose (Nasal Fracture)
- Preventing Blisters
- Hip Fracture
- Medial Collateral Ligament (MCL) Injury
- Pressure Injuries From Scuba Diving
- Pressure Injuries: Stages
- Pressure Injuries: Prevention and Treatment
- Calf Muscle Injury
- Avulsion Fracture
- Lateral Collateral Ligament (LCL) Injury
- Posterior Cruciate Ligament (PCL) Injury
- Frozen or Stuck Tongue or Other Body Part
- Fifth Metatarsal Jones Fracture
- Animal and Human Bites
- Blisters
- Burns and Electric Shock
- Choking Rescue Procedure: Heimlich Manoeuvre
- Cold Temperature Exposure
- Cuts
- Ear Problems and Injuries, Age 11 and Younger
- Elbow Injuries
- Elbow Problems, Non-Injury
- Facial Injuries
- Facial Problems, Non-Injury
- Fish Hook Injuries
- Toe, Foot, and Ankle Injuries
- Groin Problems and Injuries
- Finger, Hand, and Wrist Injuries
- Anterior Cruciate Ligament (ACL) Injuries
- Safe Hand and Wrist Movements
- Physical Rehabilitation for ACL Injuries
- Marine Stings and Scrapes
- Mouth Problems, Non-Injury
- Nail Problems and Injuries
- Puncture Wounds
- Shoulder Problems and Injuries
- Removing Splinters
- Swallowed Button Disc Battery, Magnet, or Object With Lead
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Topic Overview

What are rotator cuff disorders?
The rotator cuff is a group of tough, flexible fibres (tendons) and muscles in the shoulder. Rotator cuff disorders occur when tissues in the shoulder get irritated or damaged. Rotator cuff disorders include:
- Inflammation of the tendons (tendinitis) or of a bursa (bursitis). In the shoulder, a bursa is a small, fluid-filled sac that serves as a cushion between the tendons and the bones.
- Impingement, in which a tendon is squeezed and rubs against bone.
- Calcium buildup in the tendons, which causes a painful condition called calcific tendinitis.
- Partial or complete tears of the rotator cuff tendons.
How does the shoulder work, and what does the rotator cuff do?
The shoulder is a joint with three main bones: the upper arm bone (humerus), the collarbone (clavicle), and the shoulder blade (scapula). The bones are held together by muscles, tendons, and ligaments. The rotator cuff keeps the upper arm bone in the shoulder socket and lets you raise and twist your arm.
The shoulder is a ball-and-socket joint. The ball at the top of the upper arm bone fits into the socket of the shoulder blade. This socket is shallow, which lets you move your arm in a wide range of motion. But it also means that the muscles and tendons of the rotator cuff have to work hard to hold the bones in place. As a result, they are easy to injure and are prone to wear and tear.
What causes rotator cuff disorders?
Most rotator cuff disorders are caused by a combination of:
- Normal wear and tear. Using your shoulder for many years slowly damages the rotator cuff. As you age, everyday activities can lead to changes in the rotator cuff, such as thinning and fraying of the tendons and reduced blood supply.
- Overuse. Activities in which you use your arms above your head a lot—such as tennis, swimming, or house painting—can lead to rotator cuff problems. Even normal motions made often over a long period can stress or injure the rotator cuff.
It takes great force to tear a healthy rotator cuff tendon. This can happen during sports, a crash, or a severe fall. But even a simple movement like lifting a suitcase can cause a rotator cuff tear in an older adult or someone whose shoulder is already damaged.
What are the symptoms?
Symptoms of a rotator cuff disorder include pain and weakness in the shoulder. Most often, the pain is on the side and front of the upper arm and shoulder. It may hurt or be impossible to do everyday things, such as comb your hair, tuck in your shirt, or reach for something. You may have pain during the night and trouble sleeping.
How are rotator cuff disorders diagnosed?
To diagnose a rotator cuff disorder, doctors ask about any shoulder injuries or past shoulder pain. They also do a physical examination to see how well the shoulder works and to find painful areas or activities. Moving your arm in certain ways can help a doctor learn about the condition of the rotator cuff.
You may have an X-ray to check the bones of the shoulder. If the diagnosis is still unclear, the doctor may order an imaging test, such as an MRI or an ultrasound.
How are they treated?
It is important to treat a rotator cuff problem. Without treatment, your shoulder may get weaker and you may not be able to lift up your arm.
For most rotator cuff disorders, doctors recommend these steps first:
- Rest the shoulder. Use the arm, but do so carefully. Don't keep the shoulder still with a sling or brace. This can lead to stiffness or even a frozen shoulder (adhesive capsulitis).
- Use ice or heat on the shoulder, whichever feels better.
-
Take
anti-inflammatory drugs
(NSAIDs) to relieve pain and reduce swelling and inflammation. Examples include ibuprofen (such as Advil) and naproxen (such as Aleve). Or try acetaminophen (such as Tylenol). It can help with pain but will not reduce swelling or inflammation. Be safe with medicines. Read and follow all instructions on the label. - Avoid positions and activities that are uncomfortable, such as lifting or reaching overhead. Stop any activity that hurts the shoulder.
The doctor may also suggest physiotherapy. Physiotherapy can reduce pain and help make your shoulder stronger and more flexible. In physiotherapy, you learn exercises to stretch and strengthen your shoulder. After you learn the exercises, you can do them at home.
It is important to give treatment time to work. It may take from a couple of weeks to several months to get good results.
If other treatments don't help, your doctor may give you shots of steroid medicine in the shoulder. The shots probably don't cure rotator cuff disorders. But they can help relieve pain and inflammation so you are able to do exercises to strengthen the shoulder. The shots may also help your doctor find out if your shoulder pain is from your rotator cuff. If a steroid shot near the rotator cuff relieves your pain, even if the pain comes back later, it means the rotator cuff—not some other shoulder problem—is causing the pain.
Most rotator cuff disorders aren't treated with surgery. But doctors may do surgery if a rotator cuff tendon is torn or if several months of other treatments have not helped.
- Surgery may be a good choice if you are young and your rotator cuff has been in good shape. Surgery may not work as well if your tendons are weak and frayed.
- Surgery is not a substitute for physiotherapy. Even after surgery, you may need months of physiotherapy to have a full recovery.
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Cause
In a rotator cuff disorder, tendons that make up the rotator cuff get squeezed and rub against bone. They become damaged and irritated. This causes bleeding and inflammation. The tendons can develop scar tissue, which is not as strong and flexible as normal tendon tissue. Over time, the tendons get weaker and less flexible. Eventually, they can tear.
Normal wear and tear and overuse cause most rotator cuff problems.
It takes great force to tear a healthy rotator cuff tendon. This can happen during sports, a crash, or a severe fall. But even a simple movement like lifting a suitcase can cause a rotator cuff tear in an older adult or someone whose shoulder is already damaged.
Symptoms
A rotator cuff disorder causes pain and weakness in your shoulder. It may be uncomfortable or impossible to do everyday activities, such as combing your hair, tucking in your shirt, or reaching above your head.
Most often, you will feel the pain on the side and front of your upper arm and shoulder. You may have pain during the night and have trouble sleeping on that side. Pain is almost always worse when you make overhead movements.
Because of the pain, you may try not to use your arm. And that can cause even more weakness and stiffness in the shoulder.
The amount of pain usually depends on how much damage there is:
- Minor damage. Pain most often occurs only when you are active and is usually relieved with rest.
- Moderate damage. You will likely notice pain both during and after activity. Pain may also occur at night, especially when you lie on your shoulder.
- Severe damage. You may have continuous pain.
Sometimes the pain isn't directly related to the amount of damage. For example, your rotator cuff may have minor damage, but strength and the loss of range of motion may be severe because it's too painful to move in certain ways. This is especially true if you normally make a lot of overhead movements.
Symptoms of rotator cuff tendinitis
In tendinitis (inflammation in the tendon), the pain usually starts gradually, over the side of the shoulder and the upper arm.
- Your shoulder and arm aren't particularly weak but it hurts to use them.
- The pain may spread down the outside of the upper arm, even to the elbow.
- The pain may be worse at night and may keep you awake, especially if you lie on that side.
- Lifting the arm to the side or to the front makes the pain worse.
Over time, the pain may get worse or you may have constant pain. In some cases, this is because you actually have one or more small tendon tears.
Some people also have tendinitis in other parts of the shoulder. And some people have neck pain from using other muscles to help move the shoulder.
Symptoms of rotator cuff tears
The most common symptoms of a tear are:
- Pain when you move your arm, especially overhead or against resistance.
- Pain at night.
- Weakness in your shoulder, although some people don't notice any weakness if the tear is small.
Symptoms of a sudden, severe tear include:
- A popping sound or tearing sensation in your shoulder.
- Immediate pain in your shoulder.
- Weakness and pain when you lift or rotate your arm.
- Limited range of motion and inability to raise your arm because of pain or weakness.
- Possibly, bruising in your shoulder or upper arm.
You can have a complete tear without symptoms, especially if you are an older adult who is not very active.
In rare cases, shoulder pain may be a sign of a more serious problem with your heart or lungs.
What Happens
The rotator cuff is a group of four tendons. These tendons connect the main muscles of the shoulder to the upper arm. The tendons and muscles stabilize the shoulder joint so you can raise and rotate your arm. Every time you raise your arm above your head, the upper tendon glides under the upper end of your shoulder blade.
Sometimes the shoulder blade is rough or abnormally shaped and rubs or scrapes the tendon. Over time, this can cause tiny tears and bleeding. When these tears heal, the scar tissue is weaker and less flexible than normal tendon, so the whole rotator cuff gets weaker. The weaker the tendon becomes, the greater its chances of tearing.
Without treatment, this cycle of inflammation, wear and tear, and limited use can lead to other shoulder problems, such as stiffness or frozen shoulder. Activities that require repeated overhead arm movements can lead to problems like bursitis and tendinitis.
Here are the things that can gradually lead to rotator cuff problems. They often occur together or overlap:
- Irregularly shaped bones. These can affect how the rotator cuff moves. You may be born with these irregularities, or they may occur after some type of injury, such as a broken bone.
-
Aging. As you age, everyday activities and normal wear and tear lead to some changes in the rotator cuff, such as:
- General thinning, fraying, and tearing of the tendon.
- Reduced blood supply to the tendons.
- Joint looseness and muscle imbalance in the shoulder. This can damage tissue.
- Repetitive activities. Repeated activities, especially forceful overhead motions, are common in certain sports or occupations, including throwing a baseball, the overhead swing in tennis, swimming, lifting, or painting. These motions can eventually lead to tendons scraping against bone (impingement).
- Overuse. This may occur with or be closely related to repetitive activities. Normal motions made often over a long period can stress or injure rotator cuff tissues. Athletes, including young people, may get tendinitis from overuse in throwing, swimming, and racquet sports.
Sudden tears
It takes tremendous force to tear a healthy rotator cuff tendon. This may happen while you are playing sports or during a crash or a severe fall.
In older, less active adults, even simple movements such as lifting a suitcase can cause a tear.
What Increases Your Risk
Things that may increase the risk of rotator cuff disorders include:
- Aging.
- Having long-standing rotator cuff tendinitis.
- Holding or moving your arm overhead frequently, such as when you regularly paint; work as a waiter; or play tennis, baseball, and other throwing sports.
- Previous shoulder injuries, such as dislocations and broken bones.
- Having a rotator cuff tear in the other shoulder.
- Irregularities of the muscles, tendons, and bones in the shoulder that increase wear on the rotator cuff tendons.
- Having received multiple corticosteroid injections in the shoulder, which may weaken tendons and increase your risk.
- Smoking, which decreases the blood supply and slows the healing process.
- Shoulder instability.
As the rotator cuff and the shoulder weaken, the risk for a partial or complete tear increases.
When should you call your doctor?
Call
911
or other emergency services immediately if shoulder or arm pain occurs with chest pain or other symptoms of a heart attack, such as shortness of breath and nausea.
Call your doctor now if you have an injury to your shoulder and:
- Your shoulder is very painful.
- Your shoulder appears to be deformed.
- You cannot move your shoulder normally.
- You have signs of damage to the nerves or blood vessels, such as numbness; tingling; a "pins-and-needles" sensation below the injury; or pale, cold, or bluish skin.
Call your doctor if:
- You had a shoulder problem in the past and you have shoulder pain.
- Your shoulder pain or stiffness is getting worse.
- Home treatment isn't helping.
Watchful waiting
Watchful waiting is a wait-and-see approach. If you get better on your own, you won't need treatment. If you get worse, you and your doctor will decide what to do next. A watchful waiting period may vary from a few days to weeks or maybe months.
Examinations and Tests
To diagnose a rotator cuff disorder, your doctor will ask about your injury or shoulder pain history and will do a physical examination to see how your shoulder is working.
If your symptoms and examination show that you may have a complete rotator cuff tear, you may have one or more of these tests to confirm the diagnosis:
- X-ray
- MRI
- Ultrasound
- Arthrogram (rare)
Further testing
Your age, job, and activity level are considered when your doctor is deciding about further testing. For example, if you are a competitive athlete or have a job that requires frequent overhead activity, you may need further testing sooner than a relatively inactive older adult. A more complete diagnosis is important if you are likely to continue activities that may further damage your shoulder.
Treatment Overview
Treatment of rotator cuff disorders should begin soon after an injury or soon after symptoms develop, to give you the best chance of restoring flexibility and strength to your shoulder. Without treatment, inflammation and tears can build up, causing pain, weakness, and loss of function.
Treatment depends on your symptoms, age, and activity level, and on whether your symptoms appear to be related to a rotator cuff injury.
Non-surgical treatment
Most rotator cuff disorders are treated without surgery. Your treatment may include:
- Medicines. For more information, see Medications.
- Home treatment, such as rest and applying cold or heat. For more information, see Home Treatment.
- Physiotherapy. For more information, see Other Treatment.
If symptoms don't improve after a few months of non-surgical treatment, you and your doctor may consider testing (such as X-rays or an MRI) to find out if you have a rotator cuff tear.
Or your doctor may give you a corticosteroid shot.
Surgery
Surgery often is used to repair a torn rotator cuff in a healthy young person, because good results are more likely if there is little or no evidence of degeneration or impingement.
People who have advanced rotator cuff disorders and tendons that are tough, stringy (fibrous), and stiff usually respond less well to surgery. Surgery may successfully repair the tear, but it can't repair all the damage caused by age or degeneration.
But surgery may be considered if:
- You have a rotator cuff tear caused by a sudden injury.
- Your shoulder doesn't get better after 3 to 6 months of other treatment.
For more information, see Surgery.
What to think about
Recovery from a rotator cuff disorder varies with each person. Your physiotherapy and home exercise program should continue until your shoulder is as strong and flexible as possible. Some treatments for rotator cuff disorders can last up to a year. Most people can return to their previous activities after several weeks of rehabilitation.
Experts have differing opinions about treating rotator cuff tears.
- Some prefer non-surgical treatment for people older than 60. But other experts believe that the sooner a rotator cuff tear is surgically repaired, the better the chance of a successful outcome, regardless of age.
- Some believe that small tears do not need surgery. Other experts feel that small tears should be repaired early to prevent further tearing.
Prevention
The long-term changes that occur in and around the shoulder joint because of everyday wear and tear cannot be totally prevented. But you may be able to prevent some rotator cuff problems if you:
- Keep the muscles in your shoulders flexible and strong. Daily exercises to maintain strength and flexibility may be the best defence against rotator cuff disorders.
- Have good posture at all times. Stand straight and relaxed, without slumping.
- Don't lift objects that are too heavy for you—especially over your head.
- Don't catch falling objects.
- Avoid sports or other activities where forceful contact or falls are likely or common.
- Don't keep your arms out to the side or raised over your head for long periods of time, such as when painting a ceiling. If you must do these activities:
- Take frequent breaks, and ice your shoulder several times a day and at night.
- Take a non-steroidal anti-inflammatory drug to relieve any swelling and pain in the tissues that are being pinched. Be safe with medicines. Read and follow all instructions on the label.
- Ask your doctor if it would be helpful to take an anti-inflammatory medicine before activities that may stress your shoulder.
Home Treatment
Home treatment is often the first treatment for a rotator cuff problem. Treatment can help relieve the discomfort and keep the problem from getting worse.
-
Rest your injured shoulder, although gentle movement of the shoulder is recommended. Limit repetitive movement, and avoid strenuous activity and activities where your arms move above your head. Be sure to follow your doctor's advice on how long to limit movement. Most people don't rest long enough. The rest period for a rotator cuff disorder may be a couple of days to several weeks. During rest:
- Avoid putting your arm in a sling. It is important that you don't keep your shoulder completely still (immobilized), because it can cause the joint to stiffen or can even lead to frozen shoulder.
- Move your arm carefully through its full range of motion several times a day. Progress slowly to avoid injury.
- Avoid activities or positions that cause discomfort, such as playing golf or tennis or carrying heavy bags of groceries. Stop any activity that hurts your shoulder.
- Take non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen to relieve pain. NSAIDs come in pills and in a cream that you rub over the sore area. Be safe with medicines. Read and follow all instructions on the label.
Using ice and heat
People respond to heat and ice differently. Use whichever one makes you feel better. In some cases, heat feels good for a while but may make pain and stiffness worse after 1 to 2 hours. For a sudden injury, don't use heat for the first 48 hours.
At first, ice helps relieve pain and reduce swelling. Try applying ice to your shoulder for the first 48 hours after discomfort begins:
- To avoid harming your skin, place a thin towel between the ice pack and your body, or put a pillowcase over the ice pack.
- Apply ice 2 or 3 times a day, up to 20 minutes at a time.
- Apply an ice pack after exercising your shoulder, to help prevent swelling.
After 2 to 3 days, start moving your shoulder with the aid of moist heat:
- Soak a towel in hot water, and wring it out. Fold the towel to about 20 cm (8 in.) square.
- While holding the towel on your shoulder, relax your shoulder, lean forward so your arm hangs freely, and gently swing your arm back and forth like a pendulum.
- You also can do this exercise standing under a warm shower. Heat relaxes your muscles and tendons by increasing blood flow to them. When combined with gentle motion, heat can ease inflammation.
- Repeat these steps 2 or 3 times a day to reduce the risk of permanent stiffness in the joint.
Exercises
Eventually, your doctor may want you to do more to stretch and strengthen your shoulder. For exercises you can do at home (with your doctor's approval), see:
Medications
Medicines don't heal rotator cuff disorders. They help with pain and inflammation. This allows you to start exercises to stretch and gradually strengthen the shoulder, which reduces the risk of stiffness or a frozen shoulder.
Medicine choices
-
Non-steroidal anti-inflammatory drugs
(NSAIDs). These are the most common medicines used to help manage rotator cuff disorders. NSAIDs are available with or without a prescription. NSAIDs come in pills and in a cream that you rub over the sore area. Or you can use acetaminophen. - Corticosteroid shots. These are strong medicines that are usually given only after 3 to 4 weeks of other treatment. If the first shot doesn't help much, a second shot may be given to make sure that the first shot was given in the right place. But there is rarely a need for more than a few shots.
Be safe with medicines. Read and follow all instructions on the label.
Surgery
Surgery may be considered if:
- Your rotator cuff injury is very severe.
- You have severe pain and loss of shoulder function that haven't responded to other treatment.
- You have shoulder weakness caused by a complete tear, especially when the rotator cuff is otherwise healthy.
Surgery typically is used to repair a torn rotator cuff in a healthy young person, because good results are more likely if there is little or no evidence of other problems. People who have advanced rotator cuff disorders and tendons that are tough, stringy (fibrous), and stiff usually respond less well to surgery. Surgery may successfully repair the tear, but it can't repair all the damage caused by age or degeneration.
If surgery isn't done right away, repair of a large tear may not be as successful. But it still usually relieves pain and restores enough strength for you to do routine, non-strenuous activities.
After surgery, a program of physical rehabilitation (rehab) is very important. You may not do as well after surgery if you aren't willing or able to commit to completing a challenging physical rehab program.
Surgery choices
Shoulder surgery for rotator cuff disorders usually involves one or more of the following:
These procedures may be done arthroscopically, by traditional open surgery, or by a combination of the two approaches.
Sometimes a rotator cuff tear is so severe that it can't be fixed in the usual ways. If this happens in a younger person, the doctor may suggest moving another tendon to substitute for the torn tendon. In an older person, the doctor may suggest a special shoulder replacement.
What to think about
The success of surgery for rotator cuff tears depends on many things, such as:
- The amount of other damage present.
- Your age.
- Other medical conditions. Some may cause you to heal slower.
- Your recovery goals and commitment to and compliance with a physical rehabilitation program.
- Whether you smoke. Smoking decreases the blood supply throughout the body and slows the healing process.
Other Treatment
Physiotherapy and rehabilitation
A physiotherapy and rehabilitation (rehab) program usually involves exercises to stretch and gradually strengthen the shoulder. Some physiotherapists may use other techniques, such as massage or ultrasound, to relieve pain and reduce muscle spasms.
This program of treatment may be used without surgery or as part of recovery after surgery. It can reduce pain in the soft tissues (such as the muscles, ligaments, and tendons), improve function, and build muscle strength.
Common difficulties with rehab programs include:
- Impatience during the long periods of rest needed to let your shoulder heal. Athletes and people whose jobs depend upon the use of their arms may find it hard to be patient with this stage of treatment.
- Not doing exercises as often as prescribed.
- Using incorrect technique when doing exercises.
Although completing a rehab program may be hard, a successful outcome after surgery depends on your commitment to treatment. If you follow your physiotherapy plan closely and get help when you need it, you are more likely to restore shoulder strength and movement.
Exercises for rotator cuff disorders include:
- Gentle stretching exercises. These are often the most important part of physiotherapy for rotator cuff disorders, especially when stiffness is a major symptom. Stretching includes range-of-motion exercises.
- Strengthening exercises. In general, you won't start these exercises until your rotator cuff has healed and is able to perform the stretching and range-of-motion exercises comfortably. Strengthening exercises can help you build and keep shoulder function and stability.
- Rotator Cuff Problems: Exercises You Can Do at Home (with your doctor's approval)
Treatments being studied
Experts are studying a new treatment for chronic calcifying tendinitis of the rotator cuff. The treatment uses sound waves to create shock waves that destroy calcium deposits in the rotator cuff tendons. This is called extracorporeal shock wave therapy. Some studies show pain relief and increased range of motion. But more studies are needed to see whether these results can be duplicated and to measure long-term results.footnote 1
Other treatments being studied include:
- Acupuncture.
- Hyaluronan, which is injected into a joint to help supplement the natural synovial fluid in the joint.
Related Information
References
Citations
- George L, et al. (2002). Plasma folate levels and risk of spontaneous abortion. JAMA, 288(15): 1867–1873.
Other Works Consulted
- American Academy of Orthopaedic Surgeons and American Academy of Pediatrics (2010). Impingement syndrome. In JF Sarwark, ed., Essentials of Musculoskeletal Care, 4th ed., pp. 295–300. Rosemont, IL: American Academy of Orthopaedic Surgeons.
- Bannuru RR, et al. (2014). High-energy extracorporeal shock-wave therapy for treating chronic calcific tendinitis of the shoulder: A systematic review. Annals of Internal Medicine, 160(8): 542–549. DOI: 10.7326/M13-1982. Accessed September 3, 2014.
- Lin KC, et al. (2010). Rotator cuff: 1. Impingement lesions in adult and adolescent athletes. In JC DeLee et al., eds., DeLee and Drez's Orthopaedic Sports Medicine, Principles and Practice, 3rd ed., vol. 1, pp. 986–1015. Philadelphia: Saunders Elsevier.
- Wiesel BB, Carroll RM (2010). The shoulder. In SW Wiesel, JN Delahay, eds., Essentials of Orthopedic Surgery, 4th ed., pp. 323–351. New York: Springer.
Credits
Current as of:
July 1, 2021
Author: Healthwise Staff
Medical Review:
William H. Blahd Jr. MD, FACEP - Emergency Medicine
Brian D. O'Brien MD - Internal Medicine
Adam Husney MD - Family Medicine
Kathleen Romito MD - Family Medicine
Timothy Bhattacharyya MD
Kenneth J. Koval MD - Orthopedic Surgery, Orthopedic Trauma
Current as of: July 1, 2021
Author: Healthwise Staff
Medical Review:William H. Blahd Jr. MD, FACEP - Emergency Medicine & Brian D. O'Brien MD - Internal Medicine & Adam Husney MD - Family Medicine & Kathleen Romito MD - Family Medicine & Timothy Bhattacharyya MD & Kenneth J. Koval MD - Orthopedic Surgery, Orthopedic Trauma
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