I get asked this question all the time. I have pain in my shoulder and my MRI shows some level of rotator cuff tear. Most people assume the only way to get rid of the pain is to surgically repair the tear. But, it really depends. Many people can improve with conservative treatment of their shoulder. These people then can function very well. The next question is, “But, won’t it eventually tear more and become more of a problem?” Its a reasonable question. If it might become worse just get it over with. The other question is “If I don’t get it fixed won’t I always have issues? Surgery is a no brainer”.
My answer usually is it depends. First, what are your symptoms and how is your function? Many people assume with a tear you have a fairly non functional arm. If this is true, then surgery is probably the right call. But, many people have some shoulder pain, but are still very functional. In this case conservative management may be very helpful.
Secondly, surgery is not so easy. Many cases of conservative management can help you reduce pain and improve function in a few weeks. Rotator cuff repair is a 6-12 month rehabilitation process after surgery. And. most people are better, but any are not perfect and still have some pain and some limitations after.
The answer to the question about it tearing more anyway has been given some light in a new study. The researchers followed people with rotator cuff tears. They tried conservative management for 3 month. The ones who did not respond had repairs. The group who did respond did not have repairs. They then followed both groups for 5 years after. The group without surgery had 75% success rate after 5 years. The quality of life index in both groups was similar.
This doesn’t mean you should or should not have surgery. Its a data point. Each case should be determined by your pain, symptoms and function. Just because your MRI says tear doesn’t mean you need surgery. You are not your MRI.
Here is the link to the study.
If you have shoulder pain and aren’t sure what to do, lets talk about your options. Give us call at 970-949-9966 or ascent-pt.com