That shoulder pain when you reach overhead.
The rotator cuff is the group of four muscles and tendons that hold your shoulder together and allow you to lift and rotate your arm. When those tendons are inflamed, partially torn, or fully ruptured, everyday movements — reaching a shelf, sleeping on your side, buckling a seatbelt — become painful or impossible.
Your doctor may call this rotator cuff tendinopathy, a rotator cuff tear, or rotator cuff impingement syndrome.
Often seen within a few days — sometimes as soon as tomorrowRequest your first visit
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What rotator cuff injury really is.
Your rotator cuff isn't one structure — it's four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) whose tendons converge on the head of the humerus to form a cuff around the joint. This cuff keeps the ball of the upper arm centered in the socket and coordinates nearly every shoulder movement.
Rotator cuff problems exist on a spectrum. Tendinopathy — inflammation and degeneration of the tendon without a frank tear — is the most common cause of shoulder pain and typically responds well to conservative treatment. Partial tears involve some but not all of the tendon fibers. Full-thickness tears are a complete rupture through the tendon, which is more likely to cause significant weakness and may require surgical repair, depending on size and your functional needs.
The good news
Many rotator cuff injuries — including partial tears — improve substantially without surgery. Targeted physical therapy to strengthen the surrounding muscles, reduce impingement, and offload the damaged tendon, combined when needed with ultrasound-guided injections or platelet-rich plasma, can restore function and significantly reduce pain for the majority of patients.
Tendinopathy vs. partial vs. full tear
Clinical tests — empty can, drop arm, external rotation strength — help predict the extent of damage before imaging. MRI (or diagnostic ultrasound) confirms whether the tendon is inflamed, partially torn, or fully ruptured, and quantifies tear size. Treatment decision-making is driven by tear characteristics, functional demands, and age — a 35-year-old laborer and a 70-year-old with chronic pain have different optimal paths even with the same MRI.
Common signs we treat.
Pain lifting or reaching overhead
A predictable ache — or sharp catch — when you raise your arm above shoulder height, reach behind your back, or lift anything away from your body. The pain often peaks at mid-range and eases at full elevation.
Arm weakness
Difficulty holding your arm up, carrying weight at your side, or rotating your shoulder outward — signs that the rotator cuff's mechanical role is being compromised, not just irritated.
Pain at night lying on the shoulder
A deep, burning ache that is reliably worse at night when you roll onto the affected shoulder — one of the most characteristic complaints of rotator cuff tendinopathy and partial tears.
From hurting to healed.
We work from the least-invasive options upward, escalating only if you need it. Most patients improve well before surgery is ever discussed.
Diagnose the cause
A physician examines you and, if needed, reviews imaging to pinpoint exactly what's driving the pain.
Calm it down
Targeted physical therapy, activity guidance, and medication to settle the irritation and reduce inflammation.
Image-guided injections
If pain persists, a precisely targeted injection delivered to the source under imaging.
Advanced options
For the few who need more, minimally invasive interventional procedures — with surgery as a last resort.
Treatment is matched to your specific diagnosis at your visit. The options shown reflect NASPAC's general approach and should be confirmed against the practice's verified procedure list.
Still have questions?
Partial tears and tendinopathy often do, especially with a structured physical therapy program and appropriate injection support. Full-thickness tears generally do not fully heal on their own, but many people with full-thickness tears manage very well without surgery — particularly if pain and function are acceptable after conservative treatment. Surgery becomes a more compelling option when pain is severe, function is significantly limited, or the tear is expanding.
The two can feel identical. MRI is the gold-standard way to distinguish tendinopathy from a partial or full tear — and to determine tear size if one is present. A clinical exam gives us strong clues: progressive weakness, a positive drop-arm sign, and loss of active elevation all suggest structural damage rather than simple inflammation.
Tendinopathy with physical therapy: typically 6 to 12 weeks for meaningful improvement. Surgical repair of a full tear: 6 to 12 months for full return to demanding activity, with most daily-life function returning in the first three months. The timeline depends on tear size, repair technique, and how hard you work in post-op therapy.
We consider surgery when conservative treatment — at least 3 months of structured therapy, often with injections — hasn't produced adequate relief or function, when a full-thickness tear is causing significant weakness that isn't improving, or in younger, active patients with large or acute tears where waiting risks making a repair more complex.
Stop living with the shoulder pain.
Book with a board-certified pain physician near you — most patients are seen within days.
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