What is the best prescription for hi grade partial undersurface tear of distal supraspinatus tendon?

Family practice: I usually refer to an orthopedist for a surgical evaluation. But takin Ibuprofen and having physical therapy for a few weeks is what usually is recommended.

Arthroscopic eval: A high-grade tear of the rotator cuff acts like a full-thickness tear, although there are still some intact fibers. Injections and therapy may provide temporary relief of pain at night and with activities. The most effective may to achieve long-term pain relief and improved function is with shoulder arthroscopy. See a board certified orthopaedic surgeon for evaluation and treatment.

Rotator cuff: High grade tears generally will not heal by themselves...And will often eventually lead to full thickness tears. Surgical treatment is likely to be eventually needed. There is no harm in trying conservative treatment such as pt, nsaids, cortisone injections, etc...Just realize that this will likely just delay the inevitable.