Rotator cuff tendinitis involves inflammation of the tendons, usually from overuse or impingement. It typically causes pain with overhead activities but minimal weakness. Rotator cuff tears involve actual disruption of tendon fibers, which can be partial or full-thickness. Tears often cause significant weakness, especially with lifting or rotating the arm, and may result from acute injury or degenerative changes. While tendinitis often improves with conservative treatment, larger tears may require surgical intervention, especially in active individuals.

Yes, shoulder pain can frequently be “referred pain” from cervical spine problems. Cervical radiculopathy (pinched nerve in the neck) can cause pain radiating to the shoulder, often accompanied by numbness/tingling down the arm. Degenerative cervical conditions, herniated discs, or spinal stenosis can mimic shoulder disorders. Key distinguishing features: Neck-related pain often worsens with neck movements rather than shoulder movements, may include neurological symptoms, and shoulder examination typically shows full passive range of motion despite pain. A thorough evaluation should always assess the cervical spine when shoulder pain is present.

Frozen shoulder (adhesive capsulitis) is a condition characterized by progressive pain and stiffness in the shoulder joint. It typically progresses through three phases: freezing (increasing pain and stiffness), frozen (less pain but significant stiffness), and thawing (gradual return of motion). Treatment depends on the stage: In early stages, corticosteroid injections and gentle stretching; in frozen stage, more aggressive physical therapy, hydrodilatation (injecting sterile fluid to stretch capsule), or manipulation under anesthesia; and in later stages, continued stretching. The condition often resolves spontaneously but can take 1-3 years without treatment. Diabetes significantly increases risk.

Surgery is typically considered when Conservative treatment (3-6 months) has failed, there’s a complete rotator cuff tear in an active person, recurrent shoulder dislocations occur, advanced arthritis causes severe pain/limitation, or there’s significant functional impairment affecting daily activities. Specific indications include: Full-thickness rotator cuff tears in young/active patients, large/massive tears unlikely to heal otherwise, shoulder instability with repeated dislocations, advanced osteoarthritis unresponsive to injections, and certain fractures. The decision balances potential benefits against surgical risks, recovery time, and patient goals.

PRP injections show promising results for certain shoulder conditions, particularly: Rotator cuff tendinosis (chronic degeneration without full tear) – studies show pain reduction and functional improvement in 70-80% of cases; Partial rotator cuff tears – may promote healing and delay need for surgery; Early osteoarthritis – may provide symptomatic relief and potentially slow progression. Effectiveness varies based on patient factors, technique (ultrasound guidance improves accuracy), and post-injection rehabilitation. Typically, multiple injections are needed, with effects developing over 6-12 weeks. While not a cure for advanced conditions, PRP offers a regenerative option with minimal risk for appropriate candidates.