A rotator cuff tear is a common cause of pain and disability among adults. The incidence of this injury increases with age. The rotator cuff is made up of four muscles and tendons that run from the shoulder blade (scapula) to the top of the upper arm bone (humerus). When the rotator cuff tears, that means the tendon has detached from the bone. It is possible for the tendon to become completely detached from the bone (full-thickness tear) or for some portion of the tendon to remain attached. Tears can be acute, caused by a sudden injury or fall, or degenerative, resulting from gradual damage of the tendon.
- Pain when lifting and lowering your arm
- Pain at rest and at night
- Weakness when lifting your arm
A variety of nonsurgical treatment options can often reduce pain and improve function.
- Rest and activity modification: Avoid activities that exacerbate your pain. However, it is important to keep the shoulder moving to prevent stiffness.
- Non-steroidal anti-inflammatory medication—drugs like Ibuprofen or Naprosyn can reduce inflammation and pain.
- Physical therapy exercises can strengthen and stretch the affected muscles, which will provide more support and decrease your symptoms.
- Steroid/cortisone injections can provide a strong anti-inflammatory effect, reducing pain and allowing you to better tolerate strengthening and stretching exercises.
Non-surgical treatment can be effective, but the tear size can increase over time, and there may be persistent weakness in the shoulder. Surgical treatment involves reattaching the tendon back to the bone with a suture. It is the only way to get the rotator cuff to heal. A post-operative physical therapy program will restore function to the shoulder over time.
Surgical treatment can be successful, but there are risks associated with it. A small percentage of patients experience infection, stiffness, continued pain or a re-tearing of the tendon. Smoking, advanced age, and poor compliance with the post-operative rehabilitation program can increase the risk of complications.