Do you have shoulder pain and now having trouble using your arm above shoulder height? Your shoulder pain is likely due to damage to your supraspinatus tendon. The supraspinatus (supra-spin-ah-tus) tendon, a small but mighty connector in the shoulder, is most often injured, causing pain and limiting movement. Located in the rotator cuff, this tendon plays a crucial role in lifting the arm and performing tasks overhead. Whether due to age, overuse, or injury, this tendon is the main suspect in many shoulder problems.
In this post, you’ll learn to distinguish between inflammation and tears in the supraspinatus tendon, understand the extent of possible damage, and explore your treatment options. We also feature a video showing how acupuncture can be used to treat supraspinatus tendon issues.
What is the Supraspinatus Tendon?
The supraspinatus tendon is part of the rotator cuff, a group of four muscles and tendons surrounding the shoulder joint. This tendon connects the supraspinatus muscle (located on the upper part of the shoulder blade) to the humerus (upper arm bone). Its main function is to stabilize the shoulder and help lift the arm outward and overhead.
Shoulder Pain & Common Health Problems with the Supraspinatus Tendon
Health problems with the supraspinatus tendon are common, especially among athletes, manual laborers, and older adults. The three primary issues affecting this tendon are:
Tendonitis - inflammation of the tendon
Partial Tears - partly torn through
Full-Thickness Tears - completely torn through
Each condition involves a different level of damage and requires specific approaches to treatment.
1. Supraspinatus Tendonitis: The Starting Point of Pain
Supraspinatus tendonitis is an inflammation of the tendon, often resulting from repetitive shoulder movements or an acute injury. The inflammation causes the tendon to thicken and become irritated, leading to pain and stiffness.
Symptoms of Supraspinatus Tendonitis
Pain when lifting the arm: Especially when raising the arm to the side or overhead.
Tenderness and swelling: Around the top of the shoulder.
Limited range of motion: Difficulty moving the arm, especially when reaching for something above the head.
Pain at rest or during sleep: Often worsens at night, particularly when lying on the affected shoulder.
Diagnosis and Treatment
Supraspinatus tendonitis is often diagnosed using physical exams and imaging, like ultrasound or MRI. Treatment options include:
Rest and ice: Helps reduce inflammation.
Physical therapy: Strengthening the shoulder muscles relieves strain on the tendon.
Non-steroidal anti-inflammatory drugs (NSAIDs): Reduces pain and swelling.
Steroid injections: For severe cases, a steroid injection may help, though it’s generally a temporary solution.
2. Partial-Thickness Tears: A Step Up in Damage
Partial-thickness tears occur when the supraspinatus tendon is partially torn, usually due to wear and tear over time. These tears can cause more intense pain than tendonitis and can interfere significantly with daily activities.
Symptoms of a Partial Tear
Sharp pain when moving the shoulder: Especially during certain arm movements, like reaching up or lifting weights.
Reduced strength in the shoulder: Particularly noticeable during tasks like lifting or pushing.
Painful arc syndrome: Discomfort or pain when the arm moves within a specific range, usually around 60–120 degrees of elevation.
Diagnosis and Treatment
Partial tears are also diagnosed through physical exams, ultrasound, or MRI. Treatment typically involves:
Physical therapy: Chiropractors, and physiotherapists for strength-building exercises to support shoulder movement.
NSAIDs and pain relief medications: Helps to manage inflammation and pain.
Steroid injections: Provides temporary relief for severe pain.
Platelet-rich plasma (PRP) therapy: A newer treatment option that uses the patient’s blood platelets to promote healing, though more research is needed on its effectiveness.
3. Full-Thickness Tears: The Most Severe Injury
A full-thickness tear is a complete tear of the supraspinatus tendon, detaching it from the bone. This injury is serious and often requires more intensive treatments, possibly including surgery.
Symptoms of a Full-Thickness Tear
Severe pain: Even at rest, with significant pain during arm movement.
Complete loss of function: The shoulder may feel “frozen,” with extreme difficulty in lifting the arm.
Muscle weakness and atrophy: The muscles around the shoulder may shrink or weaken over time.
Clicking or popping sounds: Noticeable when moving the shoulder.
Diagnosis and Treatment
Full-thickness tears are usually confirmed through MRI or ultrasound. Treatment options may include:
Surgery: Often the best option for a full-thickness tear, especially if physical therapy and other methods aren’t enough.
Physical therapy: Essential post-surgery to regain movement and strength.
Pain management: NSAIDs, corticosteroids, and, in some cases, opioids may be used short-term.
Rotator Cuff Injuries vs. Supraspinatus Injuries: What's the Difference?
A rotator cuff injury and a supraspinatus injury may sound similar, but there’s an important distinction.
Rotator Cuff Injury: The rotator cuff is a group of four muscles and tendons in the shoulder—supraspinatus, infraspinatus, teres minor, and subscapularis—that work together to stabilize the shoulder and allow a wide range of motion. When someone has a rotator cuff injury, it means any one or more of these muscles or tendons may be affected. Rotator cuff injuries could involve tendonitis, tears, or impingement in any of the four muscles and can lead to a variety of symptoms depending on the specific muscles or tendons involved.
Supraspinatus Injury: The supraspinatus is one of the four muscles in the rotator cuff, and it’s especially prone to injury because of its location and frequent use in lifting and overhead motions. A supraspinatus injury specifically refers to damage or inflammation affecting only this tendon and muscle. This type of injury can lead to symptoms like pain when lifting the arm sideways or overhead, tenderness at the top of the shoulder, and pain at night.
In summary, while all supraspinatus injuries are rotator cuff injuries, not all rotator cuff injuries are limited to the supraspinatus. A rotator cuff injury may involve multiple tendons or muscles, while a supraspinatus injury specifically affects only that tendon. Identifying which muscle is affected is essential for effective treatment, as each tendon and muscle in the rotator cuff has a unique function and requires specific care.
Acupuncture for Supraspinatus Tendon Injuries
Acupuncture has gained attention as a complementary treatment for shoulder pain, especially for tendonitis and partial tears. This traditional Chinese therapy involves inserting thin needles into specific points to stimulate the body’s healing response.
Acupuncture may relieve pain by stimulating the release of endorphins, the body's natural painkillers. It’s also thought to improve blood circulation in the treated area, aiding in healing. Some studies suggest that acupuncture can reduce pain and improve function for people with shoulder problems, though results vary. A 2018 review published in the Journal of Pain Research found that acupuncture could help reduce pain in the short term, especially when combined with other treatments like physical therapy.
Effectiveness of Acupuncture
For tendonitis or partial tears, acupuncture can be beneficial in managing pain and improving range of motion. However, it may not be as effective for full-thickness tears where surgery is usually required.
While acupuncture is generally safe, it’s essential to consult a licensed practitioner who specializes in sports injuries or musculoskeletal issues to ensure the best results.
Using TENS Machines for Pain Relief
Another non-invasive treatment for supraspinatus tendon issues is Transcutaneous Electrical Nerve Stimulation (TENS). A TENS machine sends small electrical pulses to the skin, which can help relieve pain by interrupting pain signals sent to the brain.
Benefits of TENS for Supraspinatus Injuries
Pain relief without drugs: Ideal for people who can’t take painkillers.
Customizable intensity: Allows users to adjust the settings for comfort.
Portable and easy to use: Can be used at home under a doctor’s guidance.
Studies, like the one published in the Journal of Physical Therapy Science in 2016, have shown TENS to be effective for managing shoulder pain. However, TENS is usually more effective as part of a broader treatment plan, rather than a standalone solution.
Limitations of TENS
While TENS can help with pain relief, it doesn’t address the underlying injury. So, it’s generally used as a complementary treatment along with physical therapy, rest, or acupuncture.
Prevention Tips for Supraspinatus Tendon Problems
Prevention is key to maintaining shoulder health, especially for individuals at risk of supraspinatus injuries.
Regular exercise: Strengthen the shoulder muscles with exercises like wall push-ups, shoulder presses, and rotator cuff workouts.
Warm up and cool down: Before any strenuous activity, prepare the shoulder muscles to reduce strain.
Avoid overuse: Give your shoulders time to rest between activities that require repetitive arm movements.
Posture matters: Good posture helps prevent unnecessary strain on the shoulder.
Final Thoughts
Supraspinatus tendon injuries can be painful and limit daily activities, but understanding the differences between tendonitis, partial tears, and full-thickness tears can guide you toward effective treatments. For mild cases, options like acupuncture and TENS can provide relief and promote healing, especially when combined with physical therapy. However, severe injuries may require surgical intervention.
Always consult with a healthcare professional to determine the most suitable treatment plan. While home remedies and complementary therapies can be helpful, early diagnosis and tailored treatment ensure a better recovery for your shoulder.
Scientific References
Dinnes, J., Loveman, E., McIntyre, L., & Waugh, N. (2003). "The effectiveness of interventions for the treatment of rotator cuff tears: A systematic review." Health Technology Assessment, 7(29).
Lewis, J. S. (2009). "Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment?" British Journal of Sports Medicine, 43(4), 259-264.
Yang, J. L., Chen, S. Y., Chang, C. W., & Wang, S. F. (2016). "Effects of acupuncture on shoulder pain and function in patients with supraspinatus tendinitis: a randomized controlled trial." Journal of Physical Therapy Science, 28(3), 860-865.
Zeng, C., Gao, S. G., Li, H., Luo, W., Huang, J., & Lei, G. H. (2015). "Platelet-rich plasma in the treatment of patients with rotator cuff tendinopathy: a systematic review and meta-analysis." Archives of Physical Medicine and Rehabilitation, 96(10), 1821-1830.
By understanding these injuries and choosing the right treatments, you can prevent shoulder issues from keeping you down.
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