What Treatment Is Available for Rotator Cuff Injuries?

After a diagnosis is obtained following physical examination and image testing, the evaluating physician will have a better perspective of the extent of the rotator cuff injury.

If the damage is limited, surgery will not be required, and a conservative approach will be recommended to alleviate symptoms and regain proper joint use. Conservative treatment options include:

• Rest and joint immobility
• Anti-inflammatory medication
• Physical therapy
• Steroid injections

When symptoms fail to subside following non-invasive methods, surgical intervention may be the only option to repair an injured rotator cuff. This type of procedure is typically suggested if:

• Patients still experience symptoms after 6 months
• The injury is larger than 3 centimeters
• The injury results from sudden trauma or a recent tear
• Severe weakness or loss of function affects the shoulder

Surgical Treatment Options

Depending on the rotator cuff injury's severity, location, and size, the evaluating physician and surgeon will recommend the most appropriate surgical procedure to repair the damage. Patients will be under general anesthesia during the operation or will be administered a regional anesthetic and experience no discomfort or pain. 

The most common surgical interventions for rotator cuff injuries are:

• Arthroscopic Surgery – Using an arthroscope and specialized narrow instruments inserted through minor incisions in the shoulder, the surgeon can visualize the injury on a screen and repair damaged tendons in a minimally invasive manner. Recovery following arthroscopic surgery is usually faster than more invasive approaches.  
• Open Surgery – This procedure is recommended for larger and more complex tendon tears. The surgeon makes a sizeable incision to access the deltoid muscle and gently moves it out of the way to repair damaged tendons. 
• Mini-Open Surgery – In the first part of this procedure, the damaged bone and frayed tissue are repaired or removed using arthroscopic tools. During the second part of the operation, an incision is made to access the injured rotator cuff tendons and repair the injured area. 

Anchors made out of a dissolvable material and stitches may be used to help attach the tendon to the bone. After the operation is done, the surgeon closes every incision and applies a dressing.

Since the surgery is performed on an outpatient basis, patients can return home on the same day and begin the road to recovery. The surgeon will provide pain relief medication to address post-op discomfort. However, it is recommended to have a designated driver following surgery and ensure that assistance can be provided for activities that will become challenging due to shoulder immobilization.