Rotator Cuff Problems: Should I Have Surgery? You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Rotator Cuff Problems: Should I Have Surgery? Get the facts
Your options Have surgery, followed by physiotherapy. Try other treatment, including physiotherapy. Key points to remember You may be able to stop or reverse early rotator cuff damage without surgery. Try using rest, ice and heat, anti-inflammatory medicines, and physiotherapy. If you have symptoms that don't get better after 3 to 6 months, you may need surgery. You may want to think about surgery if you have torn your rotator cuff in a sudden injury and the tear is causing shoulder weakness. But surgery can't fully reverse problems that occur over time with wear and tear of the rotator cuff. Whether you choose surgery or other treatment, you will need rehabilitation and physiotherapy. Compare your options
Compare Option 1 Have rotator cuff surgery Try other treatment
Compare Option 2 Have rotator cuff surgery Try other treatment
What is usually involved?
What are the benefits?
What are the risks and side effects?
Have rotator cuff surgery Have rotator cuff surgery You are asleep or numb during surgery. If you have subacromial smoothing or rotator cuff repair using arthroscopy If you have rotator cuff repair using open surgery, you will likely go home the same day that you have surgery. Your arm will be in a sling for several weeks. After either type of surgery, you will do range-of-motion It may take a few months to recover. You get relief from your pain. You have improved shoulder strength and movement. Surgery may not restore full strength to your shoulder. You may need more physiotherapy or another surgery. Other risks of rotator cuff surgery include: Pain or stiffness that won't go away. Nerve damage. All surgery has risks, including the risks of bleeding and infection and risks related to anesthesia. Your age and your health can also affect your risk. Try other treatment Try other treatment You rest your shoulder. Gentle movement is recommended so your shoulder doesn't get stiff. You try ice packs to reduce pain and swelling. You try using moist heat during gentle shoulder movement. You take anti-inflammatory medicines You try physiotherapy to help you learn how to lift and carry objects. You avoid the risks of surgery. You avoid having surgery that you don't need if rest and physiotherapy improve the use of your shoulder. You can have surgery later if other treatment doesn't work. If you have severe shoulder weakness, rest and physiotherapy alone may not help. Without any treatment, rotator cuff disorders may get worse. Over time you may have more pain and may lose range of motion and strength in your shoulder. My shoulder has been bothering me for over a year now. The pain sometimes wakes me up at night, especially if I roll onto that side. It's also hard for me to lift things with that arm, even dishes or groceries. I've had some tests that showed a tear in one of my rotator cuff tendons. My shoulder moves better after physiotherapy, but it is still weak. My doctor is reasonably sure I will have more range of movement and less pain with arthroscopic surgery, as long as I am committed to doing all I can to prevent more problems and to following through with physiotherapy. I think I can manage a long-term rehab program.
Every time I move my shoulder a certain way, it's really painful. My range of motion has gotten better with physiotherapy, but it still hurts a lot when I move it overhead. My doctor believes that the tendons are getting pinched in one area and that surgery may help relieve the pinching and pain. I know I'm going to be doing physiotherapy for a long time still. But we agree that the surgery is reasonable to help that specific problem.
I recently started swimming, and I think the overhead movements have aggravated my shoulder and caused some tendinitis. I have a lot of pain at night, especially if I roll onto my side. I've talked to a couple of people who have had shoulder surgery, and I really hope that I don't need to. My doctor recommended that I try to rehabilitate the shoulder over the next few weeks. I'm resting it quite a bit, taking anti-inflammatory medicines, and using ice and heat to ease the pain. It seems to be working. Soon, I'll start some exercises my doctor showed me to strengthen my shoulders so that swimming doesn't hurt them.
I've had shoulder pain for quite a while now, but it got worse a few weeks ago. After resting my shoulder for a few days, I saw my doctor. He said that I had a chronic tear of my rotator cuff, judging from the symptoms I had and the ultrasound exam. He suggested that the best first step would be a good, aggressive physiotherapy program, which will also help us understand better just what the problem is. At my age, surgery takes a bit more out of me than when I was younger, so it seems worth a try to see if I can avoid it.
What matters most to you?
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Each pair of questions uses a 3 point scale where 3 is more important, 1 is less important and 0 is equally important. Use the right and left arrow keys to navigate the scale. Reasons to have rotator cuff surgery
Reasons not to have rotator cuff surgery
I think surgery and physiotherapy will help me regain the use of my shoulder faster.
I don't mind waiting longer while I try rest and physiotherapy to heal my shoulder.
More important
Equally important
More important
The risk of surgery doesn't bother me.
I'm worried about the risks of surgery.
More important
Equally important
More important
I can't do my daily activities because of my rotator cuff problems.
I'm still able to do most of my daily activities even with my rotator cuff problems.
More important
Equally important
More important
The benefits of surgery outweigh the risks for me.
I don't want to have surgery for any reason.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
Where are you leaning now?
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Use the following 3 point scale where 3 is leaning toward, 1 is may be leaning toward, and 0 is undecided. Use the right and left arrow keys to navigate the scale. Having surgery
Leaning toward NOT having surgery
Leaning toward
Undecided
Leaning toward
What else do you need to make your decision?
Check the facts 1. 1, If you have torn your rotator cuff in a sudden injury that is causing weakness in your shoulder, should you think about surgery? 2. 2, Can you limit rotator cuff damage by trying to treat it without surgery? Yes You're right. You may be able to limit early rotator cuff damage with rest, ice and heat, medicines to relieve pain and swelling, and physiotherapy. No Sorry, that's not right. You may be able to limit early rotator cuff damage with rest, ice and heat, medicines to relieve pain and swelling, and physiotherapy. I'm not sure It may help to go back and read "Get the Facts." You may be able to limit early rotator cuff damage with rest, ice and heat, medicines to relieve pain and swelling, and physiotherapy.
3. 3, Is surgery a good choice if you still have symptoms after 6 months of rest and physiotherapy? Decide what's next 1. 1, Do you understand the options available to you?
2. 2, Are you clear about which benefits and side effects matter most to you?
3. 3, Do you have enough support and advice from others to make a choice?
Certainty 1. How sure do you feel right now about your decision? Use a 7 point scale where 1 is not sure at all, 4 is somewhat sure, and 7 is very sure. Use the right and left arrow keys to navigate the scale.
Not sure at all
Somewhat sure
Very sure
2. 2, Check what you need to do before you make this decision. 3. Use the following space to list questions, concerns, and next steps.
Your Summary
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Incomplete section
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
Rotator Cuff Problems: Should I Have Surgery? Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Get the facts Compare your options What matters most to you? Where are you leaning now? What else do you need to make your decision? 1. Get the Facts Your options Have surgery, followed by physiotherapy. Try other treatment, including physiotherapy. Key points to remember You may be able to stop or reverse early rotator cuff damage without surgery. Try using rest, ice and heat, anti-inflammatory medicines, and physiotherapy. If you have symptoms that don't get better after 3 to 6 months, you may need surgery. You may want to think about surgery if you have torn your rotator cuff in a sudden injury and the tear is causing shoulder weakness. But surgery can't fully reverse problems that occur over time with wear and tear of the rotator cuff. Whether you choose surgery or other treatment, you will need rehabilitation and physiotherapy. FAQs
What is the rotator cuff? The rotator cuff is a group of four tendons
The shoulder joint ligaments
What are rotator cuff disorders? The rotator cuff tendons are a common source of shoulder problems. Over time, normal wear and tear can damage or weaken the tendons. That's even more true if the tendons are overused or if you do repeated overhead arm movements. This age-related wear and tear can cause one or more tendons to rub against the bones. This rubbing is called impingement. It also can be caused by irregularly shaped shoulder bones.
Rotator cuff disorders include:
Inflammation of the tendons (tendinitis bursitis Calcium buildup in the tendons. Partial or complete tears of the rotator cuff tendons Without any treatment—either rest and rehabilitation or surgery—rotator cuff disorders may get worse. Over time, you may have more pain. You may lose range of motion
What kinds of surgery are done to treat rotator cuff disorders? There are two types of surgery for rotator cuff disorders. They help improve strength and movement, and they also relieve pain.
Subacromial smoothing. This removes scar tissue; irregularly shaped bone; and damaged tendon bursa Rotator cuff repair. This usually starts with debridement. The repair then involves sewing the torn tendon or tendons together and reattaching them to the arm bone.Surgery may be a good choice for you if both of the following are true:
Shoulder pain or weakness limits your ability to do your daily activities, to be active, and to sleep well. These symptoms have not improved after a period of non-surgical treatment, including a well-designed physical rehabilitation program. Sudden tears, such as from a major sports injury or car crash, often are best treated with early surgery. Some kinds of tears (such as very large tears) can't be fixed, especially if you have had them for a long time. But surgery can help relieve pain by removing damaged tissue from the joint.
What are the risks of rotator cuff surgery? If your rotator cuff tendons are very weak and frayed, surgery won't work well in holding the tendon together.
After surgery, you may need to:
Avoid lifting heavy objects. Avoid doing overhead work. Avoid sports or activities that require throwing or over-the-head movement of your arm. Shoulder surgery may relieve some pain and weakness and make it easier to move your shoulder. But it may not restore full strength to your shoulder. This is even more true if you have a severe tear in the tendons or if your tendons are weak.
You may still have pain. You may need more physiotherapy or even another surgery to relieve it.
Surgery poses risks of infection, pain that won't go away, and slow healing followed by stiffness. Also, all surgeries pose some risks, such as irregular heart rhythms (arrhythmias), changes in blood pressure, and heart attack.
Surgery isn't a substitute for physiotherapy. You need to complete a physiotherapy program to have a full recovery after surgery.
What are other treatments for rotator cuff disorders? Other things besides rotator cuff problems—such as problems in the upper back—can cause shoulder pain. Shoulder pain alone without weakness or limited movement isn't a reason to have surgery.
You may be able to reverse the early stages of rotator cuff damage without surgery, by:
Resting, although gentle movement of the shoulder is advised. Holding your shoulder still for long periods, such as with slings or braces, may cause shoulder stiffness or even a frozen shoulder. Using ice packs, followed by moist heat on the shoulder. Taking anti-inflammatory medicines Avoiding positions and activities that hurt your shoulder. After you try rest and gentle movement, physiotherapy may help relieve your pain and restore strength and flexibility in weak and stiff shoulders. Physiotherapy includes exercises to:
Stretch tight shoulders. Strengthen the muscles that move the shoulder. Help you do daily activities without putting too much strain on your shoulder. You may not need surgery if:
Your shoulder gets better with physiotherapy. You have a torn rotator cuff but you are not in pain. You can do your daily activities. You don't want to do the physiotherapy program required after surgery. You have other health problems that may make surgery too dangerous. How does physiotherapy help treat rotator cuff disorders? Physiotherapy
If your shoulder joint capsule or tendons are tight, physiotherapy can help improve your range of motion Physiotherapy may strengthen the muscles that move your arm and shoulder. Physiotherapy helps you learn how to lift and carry objects and do other activities using the muscle groups that aren't hurt. This puts less stress on your injured rotator cuff tendons. Most exercise programs can be done easily on your own at home after you've learned how to do them. In most cases, you can try these exercises for several weeks to see if they help, especially if you have had shoulder problems for some time.
Why might your doctor recommend rotator cuff surgery? Your doctor may recommend rotator cuff surgery if:
You are young and your tendon tissue is strong and healthy. There is a good chance that your tear will get worse over time. You had a forceful injury to your shoulder, such as during an activity or car crash. You have severe shoulder pain or weakness. You have not gotten better after 3 to 6 months of other treatment and physiotherapy. 2. Compare your options Have rotator cuff surgery Try other treatment What is usually involved? You are asleep or numb during surgery. If you have subacromial smoothing or rotator cuff repair using arthroscopy If you have rotator cuff repair using open surgery, you will likely go home the same day that you have surgery. Your arm will be in a sling for several weeks. After either type of surgery, you will do range-of-motion It may take a few months to recover. You rest your shoulder. Gentle movement is recommended so your shoulder doesn't get stiff. You try ice packs to reduce pain and swelling. You try using moist heat during gentle shoulder movement. You take anti-inflammatory medicines You try physiotherapy to help you learn how to lift and carry objects. What are the benefits? You get relief from your pain. You have improved shoulder strength and movement. You avoid the risks of surgery. You avoid having surgery that you don't need if rest and physiotherapy improve the use of your shoulder. You can have surgery later if other treatment doesn't work. What are the risks and side effects? Surgery may not restore full strength to your shoulder. You may need more physiotherapy or another surgery. Other risks of rotator cuff surgery include: Pain or stiffness that won't go away. Nerve damage. All surgery has risks, including the risks of bleeding and infection and risks related to anesthesia. Your age and your health can also affect your risk. If you have severe shoulder weakness, rest and physiotherapy alone may not help. Without any treatment, rotator cuff disorders may get worse. Over time you may have more pain and may lose range of motion and strength in your shoulder.
Personal stories Personal stories about having rotator cuff surgery These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I recently started swimming, and I think the overhead movements have aggravated my shoulder and caused some tendinitis. I have a lot of pain at night, especially if I roll onto my side. I've talked to a couple of people who have had shoulder surgery, and I really hope that I don't need to. My doctor recommended that I try to rehabilitate the shoulder over the next few weeks. I'm resting it quite a bit, taking anti-inflammatory medicines, and using ice and heat to ease the pain. It seems to be working. Soon, I'll start some exercises my doctor showed me to strengthen my shoulders so that swimming doesn't hurt them."
"My shoulder has been bothering me for over a year now. The pain sometimes wakes me up at night, especially if I roll onto that side. It's also hard for me to lift things with that arm, even dishes or groceries. I've had some tests that showed a tear in one of my rotator cuff tendons. My shoulder moves better after physiotherapy, but it is still weak. My doctor is reasonably sure I will have more range of movement and less pain with arthroscopic surgery, as long as I am committed to doing all I can to prevent more problems and to following through with physiotherapy. I think I can manage a long-term rehab program."
"I've had shoulder pain for quite a while now, but it got worse a few weeks ago. After resting my shoulder for a few days, I saw my doctor. He said that I had a chronic tear of my rotator cuff, judging from the symptoms I had and the ultrasound exam. He suggested that the best first step would be a good, aggressive physiotherapy program, which will also help us understand better just what the problem is. At my age, surgery takes a bit more out of me than when I was younger, so it seems worth a try to see if I can avoid it."
"Every time I move my shoulder a certain way, it's really painful. My range of motion has gotten better with physiotherapy, but it still hurts a lot when I move it overhead. My doctor believes that the tendons are getting pinched in one area and that surgery may help relieve the pinching and pain. I know I'm going to be doing physiotherapy for a long time still. But we agree that the surgery is reasonable to help that specific problem."
3. What matters most to you? Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have rotator cuff surgery
Reasons not to have rotator cuff surgery
I think surgery and physiotherapy will help me regain the use of my shoulder faster.
I don't mind waiting longer while I try rest and physiotherapy to heal my shoulder.
More important
Equally important
More important
The risk of surgery doesn't bother me.
I'm worried about the risks of surgery.
More important
Equally important
More important
I can't do my daily activities because of my rotator cuff problems.
I'm still able to do most of my daily activities even with my rotator cuff problems.
More important
Equally important
More important
The benefits of surgery outweigh the risks for me.
I don't want to have surgery for any reason.
More important
Equally important
More important
My other important reasons:
My other important reasons:
More important
Equally important
More important
4. Where are you leaning now? Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having surgery
Leaning toward NOT having surgery
Leaning toward
Undecided
Leaning toward
5. What else do you need to make your decision? Check the facts 1. If you have torn your rotator cuff in a sudden injury that is causing weakness in your shoulder, should you think about surgery?
You're right. Surgery may be a good idea if you tore your rotator cuff in a sudden injury and the tear is making your shoulder weak. But surgery can't fully reverse problems that occur over time with wear and tear of the rotator cuff.
2. Can you limit rotator cuff damage by trying to treat it without surgery?
You're right. You may be able to limit early rotator cuff damage with rest, ice and heat, medicines to relieve pain and swelling, and physiotherapy.
3. Is surgery a good choice if you still have symptoms after 6 months of rest and physiotherapy?
You're right. If you have symptoms that don't get better after 6 months of rest and physiotherapy, surgery may help.
Decide what's next 1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
Certainty 1. How sure do you feel right now about your decision?
Not sure at all
Somewhat sure
Very sure
2. Check what you need to do before you make this decision.
3. Use the following space to list questions, concerns, and next steps.
Note: The "printer friendly" document will not contain all the information available in the online document some Information (e.g. cross-references to other topics, definitions or medical illustrations) is only available in the online version.
Current as of: July 31, 2024
