Treatment of a torn rotator cuff typically involves rest, physical therapy, and in certain cases, surgery. Whatever the course of treatment for a specific injury, medications are often used to treat the symptoms that come along with a torn rotator cuff. Symptomatic treatment of rotator cuff injury usually focuses upon controlling pain and reducing inflammation from the injury. Following are medications used in the treatment of torn rotator cuff injury.
Rotator Cuff Injury
Rotator cuff injury is a common injury of the shoulder that results from athletic and work-related activities that overly stress the muscles and tendons that surround the upper arm bone and shoulder joint. Most of the research on treatment for a rotator cuff injury has focused on the outcomes of conservative therapy, usually consisting of rest and physical therapy activities, or on surgical treatment of rotator cuff tears. Little research has been conducted on specific medications used to treat rotator cuff tears because medications are typically used in the treatment of pain and inflammation from the injury, not as primary treatment. Two main types of medications are used in a rotator cuff tear injury: analgesics and anti-inflammatories.
Analgesic Medications
Many medications used in treating the symptoms of rotator cuff tears are both anti-inflammatory and analgesic in nature. For example, ibuprofen is a kind of nonsteroidal anti-inflammatory drug (NSAID) which provides both pain relief and decreases inflammation at the same time. Other medications which are anti-inflammatory and analgesic include aspirin or other NSAIDs like ketoprofen or naproxen. Frequently, the pain from a rotator cuff tear may be significant enough to warrant a stronger analgesic medication. In these cases, a moderate level opioid medication like hydrocodone combined with acetaminophen (one example is the brand Lortab) may be prescribed. In patients with moderate to severe pain, oxycodone combined with acetaminophen (example brand, Percocet) or an equivalent medication may be indicated.
Anti-inflammatory Medications
Anti-inflammatory medications can include older and safer NSAIDs like ibuprofen but may also include newer drugs, such as celexicob, which is a COX-2 inhibitor. Some providers may be hesitant to prescribe COX-2 inhibitors because of potential cardiovascular side effects, but in some cases the benefits may outweigh the risks. Other drugs to consider include those like diclofenac or indomethacin. Diclofenac is an NSAID that is not often prescribed but can be effective if other drugs have not worked. Indomethacin is an older non-steroidal medication that works by blocking the production of prostaglandins, which have a role in the inflammatory process. If these medications don't provide sufficient relief, steroid injections into the area around the rotator cuff tear may be ordered by a physician as well.
References
- McConville, O. R., & Iannotti, J. P. (1999). Partial-thickness tears of the rotator cuff: evaluation and management. The Journal Of The American Academy Of Orthopaedic Surgeons, 7(1), 32-43
- Arroll, B., & Goodyear-Smith, F. (2005). Corticosteroid injections for painful shoulder: A meta-analysis. The British Journal Of General Practice, 55(512), 224-228
