https://doi.org/10.4081/ejtm.2026.15076
Abstract 077 | Shoulder tendinopathy induced by statins: a case report and systematic review, physical and rehabilitation medicine
Nicola Manocchio, Carmelo Pirri, Andrea Sorbino, Laura Giordani, Giulia Vita, Concetta Ljoka, Calogero Foti | Department of Clinical Sciences and Translational Medicine, Università degli Studi di Roma Tor Vergata, Rome, Italy.
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Published: 2 March 2026
Statins remain a cornerstone in lipid-lowering therapy but are increasingly recognized for their potential musculoskeletal side effects, including shoulder tendinopathy.(1,2) Among these, Rotator Cuff Disease (RCD) represents a frequent manifestation.(3) This study combines a systematic review analyzing the link between statin use and shoulder tendinopathy with a clinical case illustrating statin-induced RCD. A systematic review was carried out according to PRISMA 2020 guidelines, using PubMed, Web of Science, and SCOPUS databases. Alongside the review, we describe the case of a 49-year-old male who developed RCD following statin therapy escalation. The patient received a tailored individual rehabilitation project (IRP) including corticosteroid and hyaluronic acid injections, mesotherapy, and specific therapeutic exercises. From 217 initial studies, three cohort investigations satisfied the inclusion criteria. Evidence regarding the association between statin use and shoulder tendinopathy was inconsistent across studies. In the reported case, clinical symptoms improved substantially after reducing the statin dosage and implementing a multimodal, patient-centered IRP. Statins may negatively influence tendon homeostasis by altering extracellular matrix structure and cell membrane stability. While the causal relationship between statin therapy and tendinopathy remains uncertain, clinicians should actively monitor for musculoskeletal symptoms and consider treatment modifications when necessary. This case emphasizes the effectiveness of a personalized multimodal approach in managing statin-related RCD and underscores the need for further research to clarify this association and optimize patient care.
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1. Azemawah V, Movahed MR, Centuori P, Penaflor R, Riel PL, Situ S, Shadmehr M, Hashemzadeh M. State of the Art Comprehensive Review of Individual Statins, Their Differences, Pharmacology, and Clinical Implications. Cardiovasc Drugs Ther. 2019 Oct;33(5):625-639. doi: 10.1007/s10557-019-06904-x. PMID: 31773344.
2. Gowdar SD, Thompson PD. Multiple tendon ruptures associated with statin therapy. J Clin Lipidol. 2020 Mar-Apr;14(2):189-191. doi: 10.1016/j.jacl.2019.12.001. Epub 2019 Dec 5. PMID: 31899160.
3. Millar NL, Silbernagel KG, Thorborg K, Kirwan PD, Galatz LM, Abrams GD, Murrell GAC, McInnes IB, Rodeo SA. Tendinopathy. Nat Rev Dis Primers. 2021 Jan 7;7(1):1. doi: 10.1038/s41572-020-00234-1. Erratum in: Nat Rev Dis Primers. 2021 Feb 3;7(1):10. doi: 10.1038/s41572-021-00251-8. PMID: 33414454.
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