How to treat a partial rotator cuff tear and bursitis in a 68-year-old with severe shoulder pain?

Question #29719

12 days ago

How to treat a partial rotator cuff tear and bursitis in a 68-year-old with severe shoulder pain? - #29719

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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?: no Tiempo con dolor: 2meses ¿Hubo caída o golpe?: no Quisiera orientación sobre si requiere manejo conservador, infiltración o resonancia.

How long have you been experiencing this shoulder pain?:

- 1-2 months

How would you rate the severity of your shoulder pain?:

- Moderate — affects daily activities

Have you tried any treatments for your shoulder pain before?:

- Over-the-counter medication

Do you have any other symptoms associated with the shoulder pain?:

- Weakness in the arm or hand

How is your overall mobility in the shoulder?:

- Limited range but can move slightly

Have you had any previous shoulder injuries or surgeries?:

- No previous injuries or surgeries

What activities do you find most difficult due to your shoulder pain?:

- Reaching overhead

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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.

11 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.

11 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

En una situación como la que describes, tratar una rotura parcial del tendón supraespinoso con bursitis y calcificaciones de forma conservadora puede ser efectivo, pero depende de la severidad de los síntomas y la limitación funcional. Dada la intensidad del dolor (8/10) y la incapacidad para levantar el brazo, es importante actuar con prontitud para prevenir un deterioro adicional y mejorar tu calidad de vida. Primero, en cuanto al manejo del dolor, el uso de antiinflamatorios no esteroides (AINEs) como el ibuprofeno podría en principio ayudar con el control del dolor y la reducción de la inflamación. Posiblemente necesites una receta para un analgésico más fuerte si el dolor no se alivia con AINEs estándar. La fisioterapia puede ser un pilar fundamental para mejorar la movilidad y la fuerza en el hombro, reduciendo el dolor a largo plazo. Un fisioterapeuta especializado te puede ayudar a desarrollar un plan de ejercicios adecuado. Ahora bien, considerando la persistecia del dolor y la discapacidad funcional, una infiltración de corticosteroides podría ser una opción para reducir la inflamación de manera más rápida y aliviar el dolor, aunque esto debería ser evaluado por un ortopedista. En algunos casos, ante la falta de mejoría con estas medidas, una resonancia magnética podría ofrecer más detalles sobre el daño en el tendón y orientar la decisión de un posible tratamiento quirúrgico. Es vital que hables con un especialista para evaluar la opción más adecuada según tu situación específica.

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