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Rotator cuff tear & impingement

Ruptura cuffiae rotatorum · Poškození rotátorové manžety a impingement

What it is

Tendons under the acromion fray with age and overhead use.

Symptoms & signs

  • Pain lifting the arm to shoulder height
  • night pain lying on it
  • weakness
  • painful arc
  • clicking

🚩 Get help if…

  • call 112 / 911 now Shoulder pain with chest tightness, sweating or breathlessness
  • see a doctor soon Suddenly can't lift the arm after a fall or strain
  • see a doctor soon Hot, red, swollen shoulder with fever
  • see a doctor soon Shoulder that looks deformed after an injury

Where it strikes

Medical treatment

  • Physiotherapy first — as good as surgery for many tears in trials trials support
  • Steroid injection — weeks of relief, and repeated shots weaken tendon mixed evidence
  • Arthroscopic repair for full-thickness tears in younger people — a third re-tear mixed evidence
  • Reverse shoulder replacement in severe arthritis with a torn cuff trials support

Natural & lifestyle

  • Scapular stabilisation and cuff strengthening
  • activity modification
  • sleep positioning
  • posture correction

Emerging & experimental

  • Bioinductive collagen implants
  • PRP-augmented repair
  • patch grafts

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Shockwave therapy for calcific tendinitis — trials show benefit mixed evidence
  • Acupuncture — trials disagree mixed evidence
  • Prolotherapy — small trials early / small studies

ICD codes