rotator cuff disorders focuses on relieving pain and
inflammation and restoring shoulder strength, flexibility, and function.
Treatment may help to prevent further complications, such as loss of strength
and movement in the shoulder or additional degeneration or tearing. Treatment
considerations include your symptoms, age, activity level, and whether your
symptoms appear to be related to a rotator cuff injury. You and your doctor will decide together which treatment is best for you.
Most rotator cuff disorders
are treated without surgery. Your treatment may include:
- Resting, although gentle movement of the
shoulder is recommended. Prolonged immobilization (holding the shoulder still),
such as with slings or braces, may cause the shoulder joint to become stiff or
even lead to
- Applying cold or heat,
whichever helps more.
- Taking nonsteroidal anti-inflammatory drugs
(NSAIDs) or acetaminophen.
- Avoiding positions and
activities that hurt your shoulder. Usually, these are overhead positions and
- Strengthening your other shoulder muscles.
- Physical therapy, usually involving exercises to
stretch and gradually strengthen the shoulder. Physical therapy can reduce pain
in the soft tissues (muscles, ligaments, and tendons), improve function, and
build muscle strength. A
physical therapist may provide these treatments and
will also provide education, instruction, and support for recovery.
Most people with
bursitis recover without surgery. If symptoms do not
improve after a few months of nonsurgical treatment, you and your doctor may consider testing (such as X-rays or magnetic resonance
imaging) to find out if you have a rotator cuff tear. Your doctor
may consider a
corticosteroid injection if a severely inflamed tendon
or bursa does not respond to other nonsurgical treatment.
Surgery is most useful in relieving pain
and weakness in the shoulder or if the tendons are being squeezed as they move
through their normal ranges of motion. The two types of surgery for rotator
cuff disorders are
subacromial smoothing and
rotator cuff repair.
Surgery typically is
used to repair a torn rotator cuff in a healthy young person, because good
results are more likely if there is little or no evidence of degeneration or
impingement. People with advanced rotator cuff
disorders and tendons that are tough, stringy (fibrous), and stiff usually
respond less well to surgery. Surgery may successfully repair the tear, but it
cannot repair all the damage caused by age or degeneration. But surgery may be
considered for people who have:1
- A rotator cuff tear caused by a sudden
injury. In these cases, it's best to do surgery soon.
- Symptoms that do not respond well to 3 to 6 months of
nonsurgical treatment. These symptoms might include:
- Severe pain.
- Loss of shoulder strength and
- Rotator cuff problems: Should I have surgery?
What To Think About