Is it Time for Surgery To Repair Your Rotator Cuff?

A torn rotator cuff can make life miserable. In severe cases, even the simplest tasks – like reaching for a glass on a high shelf – feel impossible. The pain can also make it difficult to get a good night’s sleep.

If it gets to this point, surgery may be your best option for meaningful pain relief and restored function. But when is the right time for surgery?

How Your Rotator Cuff Works

First, let’s consider what’s happening with your rotator cuff. This group of four small muscles and tendons is responsible for keeping your shoulder joint stable and working properly. They work together to keep your arm bone (humerus) attached to your shoulder blade (scapula). This allows you to lift and rotate your arm.

There are many ways you can damage your rotator cuff – including sports injuries and accidents – but one of the most common causes is simply aging. Over the years, regular wear can eventually lead to a small tear. You may be at higher risk if you do repetitive lifting or take part in activities that require you to reach overhead. This includes tennis and softball players, painters, carpenters and mechanics.

Initially the symptoms may be so minor that you don’t even realize you have a tear. But as it progresses, symptoms can include:

• Shoulder pain: This is often a dull ache in your shoulder that gets worse at night or when you raise and lower your arm.
• Difficulty sleeping: The pain is often much worse when lying on the side with the damage. But even sleeping on the other side may not offer much relief.
• Weakened shoulder: If the tear degrades your shoulder stability, simple tasks that require reaching above your head may be a challenge. In severe cases, you may not be able to raise your arm above your chest.
• Popping or crackling in the shoulder: The damage can affect the way the ball of your humerus fits in the shoulder socket. This can cause a feeling of popping or crackling (crepitus) when you move your arm.

First Line of Treatments

The good news is that a majority of rotator cuff injuries can be treated with nonsurgical options. Among the most common:

Nonsteroidal anti-inflammatory drugs (NSAIDs): These medications – both over-the-counter and prescription strength – can help reduce pain and swelling.

Physical therapy: Working with a physical therapist can help you learn stretching and strengthening exercises to restore movement and reinforce your shoulder. The combination will help restore lost function and protect your shoulder from further injury. If you have a rotator cuff injury, make sure that your doctor or physical therapist approves any exercises involving your shoulder.

Steroid injection: Your doctor may suggest an injection that combines an anesthetic with inflammation-fighting steroids. The benefits of these shots vary from patient to patient. You may feel better for years, months or only weeks before your pain returns.

Time for Surgery?

It’s time to consider surgery when the pain doesn’t go away for any meaningful period of time using the nonsurgical options in your doctor’s toolbox.

This is particularly true if steroid injections need to be repeated multiple times each year to offer you enough relief to avoid that sleep-disabling pain at night. There are potential risks associated with repeated injections over short periods of time, so caution is advised if you are considering repeat injections as a long-term treatment alternative.

Your final decision will likely be based on a combination of your tolerance for the ongoing pain and whether you can accept the limited mobility that accompanies a worsening tear.

If you do opt for surgery, it is almost always a mini-invasive arthroscopic procedure. You can expect to have significant pain relief within the first few weeks. But depending on the severity of the tear and complexity of the repair, it can take up to six months before you completely recover your mobility and develop adequate strength for typical daily activities.

This content is not AI generated.