Therapy vs repair. Not all rotator cuff tears are treated the same. Factors such as age of patient, age of the tear, size of tear, location of the tear, and most importantly the symptoms of the patient all help determine the best course of treatment. A trial of nonoperative management with therapy and perhaps an injection is the usual 1st line of treatment. Surgery may be indicated if nonoperative treatment fails.
All tears different. First not all rot cuff tears need to be fixed.Partial and full thickness tears which are not painful or debillitating do not ned to be repaired. If you are active or the pain does not respond to pt, nonsteroidals or cortisone injection then you may need to get it fixed. If i see a 50 year old with a painful full thickness tear on the dominant side the odds are that surgery is probably needed.
Yes. Although rotator cuff tears can be treated non-operatively with pt, injections, activity modifications, you should have a discussion with your surgeon in regards to the risks and benefits of operative managemt as long standing rtc tears can lead to significant other problems like "tear arthropathy" which would seriously hinder and limit shoulder function.
Yes. Most tears will respond to non-operative measures, such as anti-inflammatory meds, physical therapy, and injections. Those that don't can be repaired surgically.