Some rotator cuff problems are easily treated at home. But if yours is severe, or lingers for more than a few months, you may need surgery.
What Causes Rotator Cuff Problems
Your rotator cuff is a group of tendons and muscles in your shoulder. It helps you lift and rotate your arm. It also helps keep your shoulder joint in place. But sometimes, the rotator cuff tendons tear or get pinched by the bones around them.
An injury, like falling on your arm, can cause this to happen. But wear and tear over time can take its toll on your shoulder, too. The pain can be severe.
Home care can treat many rotator cuff problems. Your doctor will tell you to rest your shoulder joint and ice the area. Over-the-counter pain relievers like aspirin, ibuprofen, and naproxen can help ease your pain and swelling while your rotator cuff heals. Physical therapy will help restore your shoulder strength.
What About Surgery?
If you’re not getting any relief with these steps, surgery may be the next option for you.
You may need surgery if:
- Your shoulder hasn’t improved after 6 to 12 months
- You’ve lost a lot of strength in your shoulder and find it painful to move
- You have a large tear (over 1 inch) in your rotator cuff tendon
- You’re active and rely on your shoulder strength for your job or to play sports
What Type of Surgery Do I Need?
Surgery can relieve your pain and restore function to your shoulder. Some are done on an outpatient basis. For others, you may need to stay in a hospital.
The most common types are:
Arthroscopic repair. After making one or two very small cuts in your skin, a surgeon will insert a tiny camera called an arthroscope and special, thin tools into your shoulder. These will let him see which parts of your rotator cuff are damaged and how best to fix them.
Open tendon repair. This surgery has been around a long time. It was the first technique used to repair the rotator cuff. If you have a tear that’s very large or complex, your surgeon may choose this method.
A large incision is made in your shoulder, then your shoulder muscle is detached so the surgeon has direct access to your tendon. This is helpful if your tendon or shoulder joint needs to be replaced.
Both of these surgeries can be done under general anesthesia, which allows you to sleep through the whole thing. They can also be done with a “regional block,” which allows you to stay awake while your arm and shoulder stay numb.
You can talk to your doctor ahead of time about the type of anesthesia you prefer.
Recovery from arthroscopic surgery is typically quicker than open tendon repair. Since open tendon repair is more involved, you may also have more pain right afterwards.
No matter which surgery you have, a full recovery will take time. You should expect to be in a sling for about 6 weeks. This protects your shoulder and gives your rotator cuff time to heal. Driving a car will be off limits for at least a month.
Most people don’t get instant pain relief from surgery. It may take a few months before your shoulder starts feeling better. Until then, your doctor will advise you to take over-the-counter pain relievers.
Opioid painkillers are also an option, but come with the risk of addiction. If your doctor prescribes them, it’s crucial to take them only as directed. Stop using them as soon as your pain goes away or when your pain can be controlled by other medications like acetaminophen, aspirin, ibuprofen, or naproxen.
Physical therapy will be a key part of your recovery. Your doctor will give you exercises to do every day or you can work with a physical therapist. The movements you learn will help you regain your shoulder strength and range of motion.
While the recovery from rotator cuff surgery can be a challenge, most people are back to their normal routine within 6 months.