Do I Need Surgery for a Rotator Cuff Problem?

Overview

The treatment of some rotator cuff surgery problems is possible at home. But a problem that is severe or lingers for more than a few months, may need surgery.

Rotator cuff tear is a common injury at the shoulder joint but not every rotator cuff tear causes problems that require surgery to address. 

The most common injury to the shoulder, Rotator cuff tears generally produce symptoms of weakness and pain particularly on attempting to lift the arm.

An acute injury resulting in a rotator cuff tear should be considered for surgical repair within six weeks of the injury to prevent atrophy of the muscle and tendon. 

 

Causes of Rotator Cuff Problems

A group of tendons and muscles in the shoulder, Rotator Cuff helps in lifting and rotating the arm. It also assists to keep the shoulder joint in place. However, occasionally, the rotator cuff tendons tear or get squeezed by the bones around them.

This can be caused by an injury, like falling on the arm.  But wear and tear over time can take its toll on your shoulder, too, causing severe pain.

 

Treatment

A few rotator cuff problems can be treated with home care. The doctor advises resting the shoulder joint and icing the area. 

Non-surgical treatments, including anti-inflammatory medications, physical therapy, and possibly a cortisone injection may benefit old rotator cuff tears and those that come on without an injury.

But if these fail to work, Rotator cuff surgery should be considered either to smooth out the roughness from the tear or if the tissue possesses reasonable quality & quantity to perform a surgical repair.

Patients with more constant pain, difficulty with simple activities like getting dressed, lifting household objects, or pain at night interfering with sleep may need to undergo surgical treatment.

If the symptoms do not interfere with the usual activities, then the person may not. need surgery. For example, a patient with a rotator cuff tear of the non-dominant shoulder living a sedentary lifestyle may not need surgery.

In contrast, athletic patients with injured shoulders may need surgery to return to their sport of choice.

Non-surgical treatments may help relieve symptoms of smaller tears. However, larger tears usually benefit from earlier intervention as these tears can retract, resulting in a permanently shortened tendon.

As a result, the muscle may suffer irreversible weakening. Timely surgery may help increase the likelihood of successful recovery In patients with these tears.

Surgery may be needed if:

  • The shoulder hasn’t improved after 6 to 12 months
  • There is loss of  strength in the shoulder find it is painful to move
  • There is a tear in the rotator cuff tendon
  • The patient has high activity level and relies on the shoulder strength to play sports or perform his/her job

 What Type of Surgery is Needed?

The pain can be relieved and function restored to the shoulder with surgery. Some surgeries can be performed on an outpatient basis but for most of them, one may need hospitalization.

 

The most common types of surgeries are:

Arthroscopic repair: Two very small cuts in the skin, and the surgeon inserts a tiny camera called an arthroscope and special, thin tools into the shoulder. These allow them to see which parts of the rotator cuff are damaged and the best way to fix them.

Open tendon repair: Having been around for a long time, this surgery is the first technique that has been used to repair the rotator cuff. If the tear is very large or complex, the surgeon may choose this method.

Making a large incision in the shoulder, the shoulder muscle is detached giving the surgeon direct access to the tendon. This is beneficial if the tendon or shoulder joint needs to be replaced.

 

Recovery

Recovery from arthroscopic surgery is generally faster than open tendon repair. As the open tendon repair is more complicated, one may also have more pain right afterward the surgery.

Whichever surgery you may have, the full recovery takes time. One should be prepared to be in a sling for about 6 weeks.

This safeguards your shoulder giving the rotator cuff time to heal. Driving is off-limits for at least a month.

The key part of recovery is physical therapy. The doctor recommends exercises to be performed every day or one can work with a physical therapist.

The movements learned will help to regain shoulder strength and range of motion.

Although recovering from rotator cuff surgery can be challenging, most people can return to their normal routine within 6 months

Our team at Eva Hospital under the guidance of Dr. Tanvir Bhutani is adept at treating rotator cuff problems both surgically and otherwise.

Dr.Tanveer Bhutani orthopedic doctor in Ludhiana with his precision and experience has been helping people lead pain-free and normal life. Contact for an appointment.