Are rotator cuff injuries best healed with therapy or surgery?

Cuff injuries. .. Cuff injuries aren't all the same and aren't all treated the same way. Some injuries respond well to non-operative treatment with resolution of pain and without loss of function while many require surgery to alleviate pain and/or restore strength and motion. An orthopedic surgeon experienced in the treatment of these injuries is most qualified to help you decide what the best treatment is for you.
Tear type dependent. Symptomatic tears that are partially torn (<50% of thickness) can be effectively treated without surgery. Complete tears are commonly treated with surgical repair. I always remind patients that we treat their tear and not the mri, because patients respond differently to different rotator cuff tear patterns. Asymptomatic tears certainly deserve a trial of nonoperative treatment and rehabilitation.

Related Questions

Can I heal my rotator cuff injury without surgery? I fell a couple of months ago and tore my rotator cuff muscle. The dr. Says I need surgery, but I am hesitant, because that would mean a long recovery. I am self-employed and I can't make a living witho

Often, . Often, rotator cuff tears can become "asymptomatic" with physical therapy and nsaids. However, they do not "heal". Most acute traumatic tears require a surgery and do well with appropriate rehab. While it is difficult to follow the post-op limitations, most patients are happy with their results.
I. I agree with dr. Peterson. Depending on type of rotator cuff tear, physical therapy is often an excellent option. By maximizing the muscle strength of the surrounding the other rotator cuff muscles and surrounding shoulder blade muscles, the pain associated with the tear and subsequent dysfunction may be controlled. For those who do not have success with physical therapy, surgery may improve their results. Physical therapy seems to do a little better in the degenerative type tears or the partial thickness rotator cuff tears. Usually, large full thickness rotator cuff tears tend to require surgical repair.
Omaha, . Omaha, your concerns regarding recovery and it's effects on your livelihood are extremely important in the decision making process. In the past few years, I have noted an increasing level of awareness about the length of recovery and the downside of limited activity. As you make your decision about how to maximize your recovery and minimize your down time, you are asking many important questions. In this regard, I essentially agree with all the advice you have been provided in the other fine answers. Specifically, the time line to maximal recovery and impact on your life and work will depend on several factors. Principally the pre-injury condition of your shoulder and the nature and extent of the current tear. Also if this your dominant arm and what kind of work you do specifically. If this is a new tear in an otherwise healthy shoulder a full symptomatic recovery can be expected. This may occur with rehab exercises and time (a few months) if the tear is small and partial thickness although this is not always the case as not everyone responds in this manner. In that case, or if your injury is larger and full thickness, surgery is the only method to restore the anatomy and reconnect the tendon to your bone. After surgery, depending on the size of your tear, your general health, the skill of your surgeon and success and compliance with rehab, return to work can be anywhere from a week or 2 to as much 4- 6 months. The range in return to work is very much dependent on what you do for a living. If you are a laborer, carrying and moving objects or a surgeon for example. It will take about 4 months (+/- 2) depending on the size of the tear and the success with your rehab. If you have a desk type job with minimal lifting, most folks can start typing in about 1-2 weeks and performing for a full day after about 2 weeks. Of course this assumes that you no longer require narcotic pain medication as this can effect your decision making. Patients tend to vary in this requirement, but I have seen many folks who discontinue pain medication after cuff repair surgery within the first 2 weeks, only needing it at nite for help sleeping or after a pt session. Of course if it is your dominant arm and you are a baseball pitcher the situation is very different as your recovery demands would be much greater for full performance. As for your question about "steroids" and "self healing". In general injections like steroids reduce the ability of tissue to heal by reducing inflammation. Although this often makes the shoulder feel much better, it often masks the symptoms of the tear. This can have benefit, like improved ability to do physical therapy and return to work. However, I am very careful in using steroids in the shoulder, because if one masks a true rotator cuff tear and if the tear is present for too long, it can increase in size and actually become unrepairable in worst cases. As such, I reserve the use of steroids injections for folks with "impingement syndrome" and no tears and others who have a frozen shoulder, a seperate condition beyond the scope of your questions. I hope this is helpful. Good luck dennis c. Crawford md, phd.

Rotator cuff injury and brufen - what is the best treatment for this type of shoulder injury?

It depend. If you inflammation of the rotator cuff the treatment by using anti-inflammatory medication could in form tablets or injection in the shoulder area. If you have tear of the cuff and the tear is complete you need surgery for that.

Reduced rom in right shoulder with clicking sound when elevated. Rotator cuff injury? What is best treatment plan?

Range. Of motion exercises. Avoid sleeping on that side and if symptoms persist go have imaging study.
Labral tear likely. With age less than 35 would more likely suspect internal shoulder pathology such as a torn labrum as opposed to a cuff tear that is seen more commonly in older adults. See orthopaedic evaluation to perform exam, functional testing and necessary imaging (x-ray and likely an mri).
Shoulder. Seek medical attention. A orthopedic surgeon is the best place to start. After the exam you may get radiography, physical therapy, anti inflammatory, steroid injection, linemen or surgery. Regardless you need to get to the bottom of it.
Could be. It could be an inflammed rotator cuff. The best treatment usually is anti-inflammatory medication and physical therapy. Doubtful that you have a rotator cuff tear, based on your young age.

I have a rotator cuff injury and drop arm test shows supraspinatus tear. Do I need to have surgery?

Depends. If you have a complete rotator cuff tear with weakness and night pain in your dominant shoulder then yes, at age 45 you may need surgery. You don't mention having an mri. If you do get an MRI arthrogram as it provides more information. Have you tried any physical therapy yet?
Yes. A full thickness rotator cuff tear will not heal on its own. Small tears will eventually become large tears and cause arthritis. Arthroscopic rotator cuff repair is a very successful procedure with low risk of complication. See a board certified orthopaedic surgeon for evaluation and treatment.
Depends. Http://www. Theshouldercenter. Com/rotator-cuff-tear. Htm an acute injury can result in significant weakness but not mean that there is a large tear. We need more information and a clearer extent of pathology and diagnosis. A drop arm test by itself is not sufficient to make the decision for surgery. Consider a more detailed evaluation with a shoulder specialist to review your options.

How do I know if surgery is necessary for a rotator cuff injury?

What are the symtoms. First, why do you think you have a rc problem? Your doc could take a look at you and make a diagnosis relatively easily. Mri can see a tear but not all need surgery.
Rotator cuff. If you have significant pain or difficulty raising your arm overhead then surgery may be indicated. However many rotator cuff injuries can be treated with therapy and nsaids. A MRI can help determine how significant the injury is.
Many factors. Several factors play a part in the decision to proceed with surgery including the severity of symptoms, accurate physical exam by an orthopedic surgeon, size of the tear on mri, failed nonsurgical treatments, activity level and health of each individual patient. All of the above should be taken into consideration before surgery is planned.
If torn off bone. Surgery is usually required if the tear is off the arm bone. Partial tears or strains have potential to improve with medication and physical therapy.

What does surgery for a rotator cuff injury entail?

Fix tendonto bone. Rotator cuff tears are not all the same. Partial tears are either left alone, lightly debrided or repaired. Full thickness tears often require repair of the torn tendon back to the shoulder bone (humerus, greater tuberosity). Surgery is either by open or arthroscopic technique using bone anchors and sutures to reattach the tendon to the bone. Rehabilitation is slow and deliberate for ~ 3 month.
Attach cuff to bone. A rotator cuff tear occurs when the tendon is torn off the bone. For the tendon to heal, it must be reattached to the bone. This is done arthroscopically with suture anchors. The anchors have sutures inside and are placed into the bone. The sutures are placed within the torn rotator cuff and tied down to the bone. The cuff is protected for 6 wks before therapy begins, 3-6 months for recovery.
Reattach the tendon. In surgery, the rotator cuff tendon is identified then anchored back down to the arm bone, where it tore from. It's an outpatient procedure that usually takes less than 2 hours.

I have a weird rotator cuff injury. Is it necessary to get surgery?

Not always. The decision to pursue surgical treatment depends on a number of factors, including your age, your activity level, the chronicity of the tear, the size and "repairability" of the tear. Small traumatic tears usually recover predictably well with surgery. Large atraumatic tears often respond to non-operative treatments, although there is some risk of tear progression without surgery.
Maybe. Http://www. Theshouldercenter. Com/arthroscopic-rotator-cuff-repair. Htm http://www. Theshouldercenter. Com/video-how-to-choose-a-surgeon-for-your-rotator-cuff-repair. Htm you need a clear understanding of the extent of injury and diagnosis.
It depends. See an orthopedic shoulder specialist, who can determine if you'll require surgery for the shoulder.

Is bowen therapy effective for a rotator cuff injury?

Probably Not. Bowen therapy has not been shown to be effective for rotator cuff injury. Rotator cuff injuries vary in severity - there is tendonitis, bursitis, partial tears, full thickness tears. Less severe injuries can resolve with physical therapy exercises. Some patients do report pain relief with massage to the area but this is in regards to pain and not necessarily healing of the injury.
Not likely. Bowen therapy relies on fascial and soft tissue release. It can help relieve associated pain related to neck and back muscles that often accompanies rotator cuff injuries, but the rotator cuff tendon is a deep structure and will not be directly reached. Small and partial tears can respond well to pt. Larger tears or retracted tears (pulling away from bone) usually require surgery.

I have rotator cuff injury and inflammation on both the shoulders. Will tommy johns surgery work in my case?

Wrong procedure. Tommy john surgery involves reconstructing an injured ligament in the elbow, not the shoulder. You would need a procedure involving the shoulder, but depending on your injury arthroscopic techniques to treat rotator cuff problems can be very successful.
Tommuy john. Tommy john surgery is for reconstruction of a compromised or torn medial collateral ligament of the elbow.
Elbow ligament. Tommy john surgery is reconstructive surgery of the medial ulnar collateral ligament? It is not performed for shoulder inflammation.
Not for shoulders! Tommy john surgery is for elbow instability. Tendon is used to reconstruct the ulnar collateral ligament on the inside part of the elbow. For rotator cuff injuries and tendinitis, a combination of oral/injectable steroids, nsaid's and therapy, is very effective treatment. If non-operative treatment fails, shoulder arthroscopy is the treatment of choice. See a board certified orthopaedic surgeon.