In short, determining if shoulder discomfort stems from arthritis or a rotator cuff issue depends on specific symptoms like range of motion and pain timing.
- Pain Location Matters. Arthritis often causes deep, aching pain, while rotator cuff pain is usually felt on the side of the arm.
- Movement Limitations Differ. Rotator cuff injuries limit active movement but allow passive movement; arthritis restricts both.
- Timing of Pain. Night pain is common in rotator cuff tears, while arthritis pain often worsens with weather changes or morning stiffness.
Shoulder pain can be debilitating, affecting everything from your ability to reach for a cup of coffee to getting a good night’s sleep. Because the shoulder is the most mobile joint in the body, it is susceptible to various injuries and conditions. Two of the most common culprits are arthritis and rotator cuff tears.
While both conditions cause discomfort, they have distinct characteristics. Understanding the differences can help you seek the right treatment and find relief faster.
What is Rotator Cuff Pain?
Rotator cuff pain is often caused by inflammation or a tear in the group of muscles and tendons that surround the shoulder joint. These muscles are responsible for keeping the head of your upper arm bone firmly within the shallow socket of the shoulder. They also allow you to lift and rotate your arm.
When these tendons are irritated or torn, you may experience significant weakness. A rotator cuff injury is frequently associated with repetitive overhead motions, making it common among painters, carpenters, and baseball players. However, it can also occur due to sudden trauma or simply age-related wear and tear.
Common Symptoms of a Rotator Cuff Injury
If you suspect a rotator cuff issue, pay attention to where and when you feel the pain. The following symptoms are classic indicators:
- Pain on the side of the arm. The pain often travels down the outside of the upper arm but rarely goes past the elbow.
- Weakness when lifting the arm. You may struggle to lift your arm above your head or reach behind your back.
- Night pain. Pain often worsens at night, especially if you lie on the affected shoulder.
- Crackling sensation. You might feel or hear a crackling sound (crepitus) when moving the shoulder in certain positions.
A key distinction in rotator cuff pain is the difference between active and passive motion. With a rotator cuff tear, you might not be able to lift your arm yourself (active motion) because of weakness or pain. However, if someone else lifts your arm for you (passive motion), the joint can usually move through its full range.
What is Shoulder Arthritis?
Shoulder arthritis involves the wearing down of the smooth cartilage that covers the ends of the bones in the shoulder joint. As this cartilage deteriorates, the bones begin to rub against each other. This friction causes inflammation, stiffness, and pain.
There are several types of arthritis, but osteoarthritis is the most common form affecting the shoulder. It is a degenerative condition that typically develops slowly over many years.
Common Symptoms of Shoulder Arthritis
Arthritis pain presents differently from tendon pain. Look for these signs:
- Deep, aching pain. The pain is often felt deep inside the joint or in the back of the shoulder.
- The range of motion becomes limited in all directions.
- Grinding sensation. You may feel a grinding or clicking sensation when moving the shoulder.
- Pain that worsens with activity. The pain may intensify after vigorous use of the arm, but can also ache when resting.
Unlike a rotator cuff injury, arthritis limits both active and passive range of motion. Because the joint surfaces are rough or deformed, the shoulder physically cannot move as far as it used to.
Key Differences Between Arthritis and Rotator Cuff Injuries
Distinguishing between rotator cuff pain and arthritis can be tricky, as they can sometimes occur simultaneously. However, certain factors help tell them apart.
Range of Motion
This is often the most telling sign. If your shoulder feels “locked” or stiff in all directions, arthritis is the likely cause. If the shoulder feels loose or weak, specifically when lifting the arm overhead or reaching away from the body, it points toward a rotator cuff problem.
Nature of the Pain
Arthritis pain is typically a dull ache that can fluctuate with the weather. Rotator cuff pain is often sharper, particularly when making specific movements like reaching for a seatbelt or brushing your hair.
Onset of Symptoms
Arthritis usually develops gradually. You may notice stiffness for months or years before the pain becomes severe. A rotator cuff injury can happen suddenly from a fall or lifting a heavy object, though degenerative tears also happen slowly over time.
Diagnosis and Imaging
To confirm whether you have a rotator cuff injury or arthritis, a doctor will perform a physical exam and order imaging tests.
Physical Examination
During the exam, your doctor will check your range of motion, strength, and areas of tenderness. They may use specific maneuvers to isolate different muscles and tendons.
X-rays
X-rays are excellent for diagnosing arthritis. They reveal the narrowing of the joint space, bone spurs, and bone deformities.
MRI and Ultrasound
Magnetic resonance imaging (MRI) or ultrasound is necessary to visualize the rotator cuff tendons. These tests can show inflammation, partial tears, or complete tears.
Treatment Options
Treatment depends on the diagnosis, severity of symptoms, and your activity goals.
Treating Rotator Cuff Pain
Conservative care is often the first step.
- Rest and activity modification. Avoiding overhead activities helps reduce inflammation.
- Physical therapy. Strengthening the surrounding muscles can compensate for the torn tendon.
- Anti-inflammatory medication. Drugs like ibuprofen (Advil) or naproxen (Aleve) can reduce pain and swelling.
- Steroid injections. A cortisone shot can provide temporary relief to allow for physical therapy.
If conservative measures fail or if the tear is acute and severe, surgery may be recommended to repair the tendon.
Treating Shoulder Arthritis
Arthritis treatment focuses on pain management and maintaining function.
- Physical therapy. Gentle range-of-motion exercises prevent the shoulder from stiffening further.
- Heat and ice. Applying heat can loosen a stiff joint, while ice can reduce pain after activity.
- Injection therapy. Cortisone or hyaluronic acid injections may provide relief.
- In advanced cases, shoulder replacement surgery may be considered.
Interestingly, sometimes a patient has rotator cuff pain but is found to have arthritis, as well. This condition, known as cuff tear arthropathy, requires a specialized treatment approach, often involving a specific type of joint replacement called a reverse total shoulder arthroplasty.
When Should You See a Doctor?
You should not ignore persistent shoulder pain. Early intervention can prevent conditions from worsening. Seek professional help if you experience:
- Inability to carry objects or use the arm.
- Shoulder pain that persists for more than a few weeks.
- Severe pain that interferes with sleep.
- Signs of infection, such as fever or redness around the joint.
Expert Shoulder Care for Rotator Cuff Pain in Northeast Tennessee and Southwest Virginia
If you are struggling with persistent rotator cuff pain or suspect arthritis is limiting your life, do not wait for the condition to worsen. Getting an accurate diagnosis is the first step toward recovery and a pain-free lifestyle.
At Watauga Orthopaedics, our team of specialists is dedicated to helping you regain your strength and mobility. We offer comprehensive evaluations and personalized treatment plans tailored to your specific needs.
Call Watauga Orthopaedics today at (423) 282-9011 or schedule your appointment online to get back to doing what you love.
