Orthopedics & Sports Medicine Expert Forum
Rotator Cuff Tear AND Calcific Tendonitis - 28 yrs old
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Rotator Cuff Tear AND Calcific Tendonitis - 28 yrs old

Dear Doctor,

Unfortunately, I cannot see my treating doctor until next week, and I am already less than enthused with his performance to date.  As such, I would greatly appreciate it if you could look over my case and provide some insight, particularly regarding what is causing my pain and whether I need might need surgery.  My story is as follows:

Halfway through March (2012) I began experiencing soreness and tightness in my right shoulder; however, the pain was not debilitating.  It bothered me slightly in the morning but would improve as the day went on.  This changed last week after I unintentionally slept directly on the affected shoulder (with all my weight pressed upon it).  I woke up in considerable pain.  Worse, I could not raise my arm at all.  X-rays showed that I had calcific tendonitis.  My treating doctor expressed disbelief that I was in as much pain as I was (it was difficult for me to even write).  Nevertheless, he gave me a cortosteroid injection in my arm and, reluctantly, Tylenol 3 as well.  He also referred me for an MRI, despite saying he would be shocked if I had a tear.

Since then the pain has only gotten worse, and I still cannot raise my arm.  I am in a lot of pain, to the point where it is hard to concentrate and complete daily activities.  Moreover, my MRI results revealed the following: "Minor inflammation of subdeltoid bursa.  Under 1.0 cm partial thickness tear involving the insertional fibers of the supraspinatus tendon on the articular surface.  Focal low sensitivity is seen adjacent to the bursal fibers suggesting evidence of calcific tendonitis."

My questions are 1) What does this report suggest exactly? 2) What is more likely causing my intense pain, the calcific tendonitis, the tear, or both? 3) Does this situation sounds like surgery is needed? and 4 ) If surgery is not needed, what can I do to feel better? I can barely do anything and I obviously don't want to become reliant on painkillers.
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