Rotator cuff tendonitis in lymphedema: a retrospective case series.

Objectives: To report rotator cuff tendonitis as a complication of lymphedema and to discuss the possible etiology and treatment options.

Design: Retrospective review of 8 cases.

Setting: University hospital outpatient clinic.

Participants: A total of 8 breast cancer patients with a history of lymphedema and ipsilateral shoulder pain.

Intervention: Patients with lymphedema and ipsilateral shoulder pain were diagnosed with rotator cuff tendonitis if all of the following 3 tests were positive: supraspinatus test, Neers impingement test, and Hawkins impingement test. Patients diagnosed with rotator cuff tendonitis were prescribed a nonsteroidal anti-inflammatory drug (NSAID) and physical therapy (PT).

Main Outcome Measures: Improvement in symptoms of shoulder pain at a 4- to 6-week follow-up, as measured by visual analog scale (VAS).

Results: Seven of 8 patients reported a subjective decrease in their symptoms of shoulder pain at a 4- to 6-week follow-up. The average improvement in shoulder pain as measured by VAS was a 4.5-point decrease from the original pain score given. One of 8 patients had a full-thickness supraspinatus tendon tear and required additional decongestive therapy and PT to obtain relief of symptoms.

Conclusions: Rotator cuff tendonitis is a complication of lymphedema caused by internal derangement of tendon fibers, which may be subject to impingement, functional overload, and intrinsic tendinopathy. Conservative treatment with NSAIDs and PT is a safe and effective treatment.