When is rotator cuff surgery necessary

The main aim of these treatment plans is to reduce pain and increase strength in the shoulder muscles. Your doctor will do a thorough diagnosis before helping you choose a treatment plan. You may also be required to go in for a diagnostic imaging test, such as an ultrasound or MRI, to confirm a diagnosis.

Visiting the doctor for early diagnosis and treatment is very important. Occasionally, patients younger than 35 get partial tears of the rotator cuff. These tears may be associated with an injury. Partial rotator cuff tears are common in people who are overhead athletes they play sports with an upper arm and shoulder arc over the head , such as pitchers in baseball. Partial rotator cuff tears in competitive athletes are treated the same way as partial tears in aging adults.

A partial tear goes only part of the way into the tendon. A full-thickness tear is when the wear in the tendon goes all the way through the tendon.

Partial tears can be just 1 millimeter deep only about 10 percent of a tendon , or can be 50 percent or deeper. When a radiologist looks at an MRI scan, he or she must make a judgment about the type of the rotator cuff changes.

They must decide if the changes are tendinosis, a partial tear or a full tear. Sometimes it is not possible to distinguish tendinosis from a partial tear, or a partial tear from a full tear. It takes experience and practice to be able to read MRI scans of the rotator cuff tendons. Not all patients with partial rotator cuff tears have symptoms, but those who do may experience pain in the shoulder. Generally, the most painful motion with a partial rotator cuff tear is lifting things over the shoulder level or far away from the body.

Lifting in this manner is very stressful on the shoulder. Many activities may not hurt at all, including running, cycling, swimming, lifting weights, etc. If you do have pain, you can try cutting back on that exercise or activity, but there is no evidence that continuing the activity will worsen the tear. I've had shoulder pain for quite a while now, but it got worse a few weeks ago. After resting my shoulder for a few days, I saw my doctor.

He said that I had a chronic tear of my rotator cuff, judging from the symptoms I had and the ultrasound examination. He suggested that the best first step would be a good, aggressive physiotherapy program, which will also help us understand better just what the problem is.

At my age, surgery takes a bit more out of me than when I was younger, so it seems worth a try to see if I can avoid it. Every time I move my shoulder a certain way, it's really painful. My range of motion has gotten better with physiotherapy, but it still hurts a lot when I move it overhead. My doctor believes that the tendons are getting pinched in one area and that surgery may help relieve the pinching and pain.

I know I'm going to be doing physiotherapy for a long time still. But we agree that the surgery is reasonable to help that specific problem. Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements. I think surgery and physiotherapy will help me regain the use of my shoulder faster. I don't mind waiting longer while I try rest and physiotherapy to heal my shoulder.

I'm still able to do most of my daily activities even with my rotator cuff problems. Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now. How sure do you feel right now about your decision? Use the following space to list questions, concerns, and next steps.

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision. I can't do my daily activities because of my rotator cuff problems. If you have torn your rotator cuff in a sudden injury that is causing weakness in your shoulder, should you think about surgery? Can you limit rotator cuff damage by trying to treat it without surgery? Is surgery a good choice if you still have symptoms after 6 months of rest and physiotherapy?

Are you clear about which benefits and side effects matter most to you? Do you have enough support and advice from others to make a choice? Author: Healthwise Staff. Medical Review: William H. Blahd Jr. This information does not replace the advice of a doctor. Healthwise, Incorporated, disclaims any warranty or liability for your use of this information.

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Get the facts. Your options Have surgery, followed by physiotherapy. Try other treatment, including physiotherapy. Key points to remember You may be able to stop or reverse early rotator cuff damage without surgery. Try using rest, ice and heat, anti-inflammatory medicines, and physiotherapy. If you have symptoms that don't get better after 3 to 6 months, you may need surgery. You may want to think about surgery if you have torn your rotator cuff in a sudden injury and the tear is causing shoulder weakness.

But surgery can't fully reverse problems that occur over time with wear and tear of the rotator cuff. Whether you choose surgery or other treatment, you will need rehabilitation and physiotherapy.

What is the rotator cuff? What are rotator cuff disorders? Rotator cuff disorders include: Inflammation of the tendons tendinitis or the bursa bursitis. Calcium buildup in the tendons. Partial or complete tears of the rotator cuff tendons.

Partial tears are common when the rotator cuff is already damaged or weakened. A complete rotator cuff tear in someone with an otherwise healthy shoulder is often caused by a forceful injury, such as during sports or a car crash.

What kinds of surgery are done to treat rotator cuff disorders? Subacromial smoothing. This removes scar tissue; irregularly shaped bone; and damaged tendon , bursa , and debris from the joint debridement. A rotator cuff tear that is the result of aging, called a degenerative tear of the rotator cuff, must be distinguished from a tear that is the result of a traumatic injury to the shoulder.

There is some crossover, where the chronic weakening of the rotator cuff from aging degenerating leads to susceptibility to tearing from relatively minor trauma.

Therefore, each individual likely has components of both degenerating and trauma that contribute to their shoulder problem, and your orthopedic surgeon can help determine why your tear occurred. Treatment of a torn rotator cuff varies depending on the type of injury and the type of patient.

Since a rotator cuff tear often exists in people with no symptoms of a tear, treatment does not necessarily need to include repairing the torn tendon.

Most often, simple treatments are tried first. Consideration of a surgical repair is only made if these simple treatments fail to provide relief. There are some exceptions, and some people with rotator cuff tears may be better off with immediate surgery.

These tend to include younger patients who have had a recent acute injury to their shoulder. In these people, a rotator cuff tear is not normal and not primarily the result of the aging process.

Rotator cuff surgery may be an appropriate option for shoulder pain resulting from a rotator cuff tear. However, simply having a rotator cuff tear is not a reason in and of itself to have surgery.

The decision about when surgery is appropriate is complicated and depends on a number of factors that you need to discuss with your healthcare provider. The majority of rotator cuff tears will never require surgery, and many people can find relief with non-surgical treatments. Patients who are told they need rotator cuff surgery should understand the reason for surgery. In most cases, non-surgical treatments should be attempted first, the exception being in younger patients who have rotator cuff tears resulting from traumatic injuries.

If you are unsure of the necessity of a rotator cuff surgery, a second opinion can be helpful. Dealing with joint pain can cause major disruptions to your day.