A: Certain signs such as night pain, difficulty with overhead activities and functional weakness can indicate a rotator cuff tear. If the tears are painful or cause weakness, then they should be addressed. Typically early treatment is conservative with anti-inflammatories and physical therapy, assuming it is not an acute injury.
If these treatments don’t solve the problem, then an injection in the bursa around the rotator cuff can be very effective, and when coupled with physical therapy, may be all the patient needs. We now have the ability not only to look at the health of the rotator cuff with ultrasound in the office, but also put an injection exactly where it needs to go under ultrasound guidance. There is no scientific proof a rotator cuff will heal without intervention. Unfortunately, most tears typically progress and get bigger with time, so it’s important they are treated.
If a patient still has persistent pain or weakness, arthroscopic rotator cuff surgery has proven to be just as effective as open rotator cuff surgery and allows the surgeon to address the shoulder all inclusively with three to four very small incisions. Arthroscopic rotator cuff repair is an outpatient surgery and can reliably alleviate pain and help restore function to the shoulder.
Information provided by Dr. Jason Sullivan, Sports Medicine, knee, hip and shoulder surgeon. Des Moines Orthopaedic Surgeons, 6001 Westown Parkway, West Des Moines, 515-224-4250.