What to do for right shoulder pain with partial rotator cuff tear and bursitis in a 68-year-old?

Question #29718

12 days ago

What to do for right shoulder pain with partial rotator cuff tear and bursitis in a 68-year-old? - #29718

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Tengo dolor de hombro derecho 8/10. Ecografía: rotura parcial del tendón supraespinoso + bursitis subacromio-deltoidea + calcificación tendinosa. Edad: 68 años ¿Puedo levantar el brazo?: si Tiempo con dolor: 2 meses ¿Hubo caída o golpe?: no Quisiera orientación sobre si requiere manejo conservador, infiltración o resonancia.

How would you describe the pain in your shoulder?:

- Sharp and stabbing

Does the pain radiate to any other areas?:

- Yes, to the neck

Have you noticed any weakness in your arm?:

- Yes, some weakness

What activities increase your shoulder pain?:

- Reaching overhead

Have you tried any treatments for your shoulder pain?:

- Injections

How is your overall mobility with the shoulder?:

- Limited range but can lift

Do you have any other medical conditions?:

- High blood pressure

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Doctors' responses

Dr. Bharat Joshi

I’m a periodontist and academician with a strong clinical and teaching background. Over the last 4 years and 8 months, I’ve been actively involved in dental education, guiding students at multiple levels including dental hygienist, BDS, and MDS programs. Currently, I serve as a Reader at MMCDSR in Ambala, Haryana—a role that allows me to merge my academic passion with hands-on experience. Clinically, I’ve been practicing dentistry for the past 12 years. From routine procedures like scaling and root planing to more advanced cases involving grafts, biopsies, and implant surgeries. Honestly, I still find joy in doing a simple RCT when it’s needed. It’s not just about the procedure but making sure the patient feels comfortable and safe. Academically, I have 26 research publications to my credit. I’m on the editorial boards of the Archives of Dental Research and Journal of Dental Research and Oral Health, and I’ve spent a lot of time reviewing manuscripts—from case reports to meta-analyses and even book reviews. I was honored to receive the “Best Editor” award by Innovative Publications, and Athena Publications recognized me as an “excellent reviewer,” which honestly came as a bit of a surprise! In 2025, I had the opportunity to present a guest lecture in Italy on traumatic oral lesions. Sharing my work and learning from peers globally has been incredibly fulfilling. Outside academics and clinics, I’ve also worked in the pharmaceutical sector as a Drug Safety Associate for about 3 years, focusing on pharmacovigilance. That role really sharpened my attention to detail and deepened my understanding of drug interactions and adverse effects. My goal is to keep learning, and give every patient and student my absolute best.

12 days ago

Hello dear
As per clinical history it seems w rotator cuff disorder
It involves inflammation of supraspinatus tendon
Bursitis
calcium deposition
It causes
Limited arm movement
Significant pain
Swelling
Pseudoparalysis
It requires following tests for confirmation.
Please share the result with orthopedic surgeon in person for better clarity and for safety please donot take any medication without consulting the concerned physician
Esr
CBC
Mri
Arthrography
Shoulder USG
There may be requirement of
Rest
Physiotherapy
Medication like
Diclofenac sodium gel topical application
Crave bandage application
Limited stretching
Selective cox -2 inhibitors like
Refecoxicib
Hopefully you recover soon
Regards

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Dr. Arsha K Isac

I am a general dentist with 3+ years of working in real-world setups, and lemme say—every single patient teaches me something diff. It’s not just teeth honestly, it’s people… and how they feel walking into the chair. I try really hard to not make it just a “procedure thing.” I explain stuff in plain words—no confusing dental jargon, just straight talk—coz I feel like when ppl *get* what's going on, they feel safer n that makes all the difference. Worked with all ages—like, little kids who need that gentle nudge about brushing, to older folks who come in with long histories and sometimes just need someone to really sit n listen. It’s weirdly rewarding to see someone walk out lighter, not just 'coz their toothache's gone but coz they felt seen during the whole thing. A lot of ppl come in scared or just unsure, and I honestly take that seriously. I keep the vibe calm. Try to read their mood, don’t rush. I always tell myself—every smile’s got a story, even the broken ones. My thing is: comfort first, then precision. I want the outcome to last, not just look good for a week. Not tryna claim perfection or magic solutions—just consistent, clear, hands-on care where patients feel heard. I think dentistry should *fit* the person, not push them into a box. That's kinda been my philosophy from day one. And yeah, maybe sometimes I overexplain or spend a bit too long checking alignment again but hey, if it means someone eats pain-free or finally smiles wide in pics again? Worth it. Every time.

12 days ago

Hello
Con una rotura parcial del supraespinoso + bursitis subacromial y calcificación, y 2 meses de dolor con dificultad para elevar el brazo, el manejo suele empezar conservador, pero con un umbral bajo para escalar si no mejora.
Primero, reposo relativo (evitar levantar peso y movimientos por encima de la cabeza), analgésicos/antiinflamatorios si los tolera, y fisioterapia dirigida (movilidad suave + fortalecimiento progresivo del manguito rotador y escápula). El objetivo es recuperar rango de movimiento y disminuir la inflamación.
La infiltración subacromial con corticoide es una muy buena opción en su caso si el dolor limita mucho la rehabilitación; suele aliviar la bursitis y permite avanzar con fisioterapia. Para la calcificación, en algunos casos se usa lavado/barbotaje guiado por ecografía.
La resonancia no es obligatoria de entrada si ya hay ecografía clara, pero se recomienda si no mejora tras 6–8 semanas de tratamiento adecuado, o si hay sospecha de que la rotura sea mayor de lo que parece.
Cirugía se reserva para dolor persistente, incapacidad funcional importante o progresión a rotura completa.
En resumen: iniciar o intensificar fisioterapia + considerar infiltración ahora; y pedir resonancia si no hay mejoría en pocas semanas o si la movilidad sigue muy limitada.
Take care

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Dr. Aarav Deshmukh

I am a general physician with 8 years of practice, mostly in urban clinics and semi-rural setups. I began working right after MBBS in a govt hospital in Kerala, and wow — first few months were chaotic, not gonna lie. Since then, I’ve seen 1000s of patients with all kinds of cases — fevers, uncontrolled diabetes, asthma, infections, you name it. I usually work with working-class patients, and that changed how I treat — people don’t always have time or money for fancy tests, so I focus on smart clinical diagnosis and practical treatment. Over time, I’ve developed an interest in preventive care — like helping young adults with early metabolic issues. I also counsel a lot on diet, sleep, and stress — more than half the problems start there anyway. I did a certification in evidence-based practice last year, and I keep learning stuff online. I’m not perfect (nobody is), but I care. I show up, I listen, I adjust when I’m wrong. Every patient needs something slightly different. That’s what keeps this work alive for me.

10 days ago

Para el dolor de hombro con un desgarro parcial del tendón del supraespinoso, bursitis subacromio-deltoidea y calcificación tendinosa, el manejo inicial generalmente puede ser conservador. Esto incluye descanso del brazo afectado, evitando actividades que provoquen dolor. La aplicación de frío en la zona afectada durante 15-20 minutos, varias veces al día, puede ayudar a reducir la inflamación. También puedes hablar con tu médico sobre el uso de analgésicos o antiinflamatorios no esteroides (AINEs) como ibuprofeno para manejar el dolor, asegurándote de que no haya contraindicaciones médicas para su uso en tu caso. La fisioterapia también es una parte fundamental del tratamiento conservador. Un fisioterapeuta puede enseñarte ejercicios específicos para mejorar la movilidad del hombro y fortalecer los músculos del manguito rotador. Esta intervención es generalmente clave en la recuperación a largo plazo. En cuanto a la infiltración con corticoides, esta puede considerarse si el dolor es intenso y no se alivia con las medidas conservadoras, pero debe ser evaluada por un médico ortopedista. Respecto a la resonancia magnética, en este momento puede que no sea estrictamente necesaria, ya que ya tienes un diagnóstico por ecografía; ésta podría ser indicada si no hay mejoría con el tratamiento o para planificar potenciales intervenciones quirúrgicas si fuera necesario más adelante. Siempre debes consultar con un especialista en ortopedia para revisar más a fondo el caso y ajustar el tratamiento según tus necesidades y comorbilidades.

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