Symptoms of a rotator cuff disorder include pain and weakness in your shoulder. It may be uncomfortable or impossible to do everyday activities, such as combing your hair, tucking in your shirt, or reaching above your head. Most often, you will feel the pain on the side and front of your upper arm and shoulder. You may have pain during the night and experience trouble sleeping on the affected side.¹

The amount of pain varies, although it often increases when you raise your arm above the shoulder. The pain usually is closely related to the degree of damage. It is almost always worse when making overhead movements.

• Minor damage: Pain most often occurs only when you are active, and is usually relieved with rest.
• Moderate damage: You will likely notice pain both during and after activity. Pain may also occur at night, especially when you lie on your shoulder.
• Severe damage: You may have continuous pain.

Pain may result in limited use, which can cause more weakness and stiffness in the shoulder. Pain that affects function is not always directly related to the amount of damage to the rotator cuff. For example, your rotator cuff may have minor damage, but strength and the loss of range of motion may be severe because it is too painful to move in certain ways. This is especially true if you normally make a lot of overhead movements.

Symptoms of rotator cuff tendinitis

Pain is the main symptom of inflammation in the tendon (tendinitis). The pain usually starts gradually, over the side of the shoulder and the upper arm. The shoulder and arm will not be particularly weak but are painful when they are being used. The pain may radiate down the outside of the upper arm, even to the elbow. The pain may be worse at night and may interfere with sleep, especially if you lie on the injured shoulder. Lifting the arm to the side (abduction), especially when combined with a forward movement (forward flexion), makes the pain worse.

Eventually, you may have continuous pain. In some cases, this "tendinitis" may actually be one or more small tendon tears.

Rotator cuff tendinitis may be linked to inflammation in adjacent structures, which can result in conditions such as tendinitis in the biceps tendons or inflammation of the subacromial bursa (bursitis). Some people have neck pain from using other muscles to help move the shoulder.

Symptoms of rotator cuff tears

The most common symptoms of a partial tear are:

• Pain when moving your arm, especially against resistance.
• Weakness in your shoulder, although some people don't notice any weakness.

Symptoms of a sudden, severe (acute) tear include:

• A popping sound or tearing sensation in your shoulder.
• Immediate pain in your shoulder.
• Weakness when lifting or rotating your arm.
• Limited range of motion and inability to raise your arm because of pain or weakness.
• A crackling sound in the shoulder when it is moved.
• Possibly, bruising in your shoulder or upper arm.

A complete tear can be present without obvious symptoms, especially in an older adult who is not very active.

In some cases, shoulder pain may be a sign of a more serious problem, such as a heart attack. If you have other symptoms such as chest pain, sweating, shortness of breath, or nausea, callor other emergency services. For additional information, see the topic Chest Problems.

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