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Non-Surgical Treatments for Rotator Cuff Tears

Treatment Options for a Torn Rotator Cuff

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Updated October 04, 2011

Rotator cuff tears do not heal well with time. They tend to either enlarge, or, at best, stabilize in size. The good news is the rotator cuff tears do not necessarily need to heal in order for the symptoms to resolve. Many people have rotator cuff tears, but no symptoms of shoulder pain. Therefore, the goal of treatment of a rotator cuff tear is to relieve the symptoms, not necessarily heal the tear.

1. Rest

When the symptoms of a rotator cuff tear are acute, meaning there is a sudden flare-up of symptoms, it may be helpful to rest the shoulder to allow the inflammation of the injury settle down. It is important to not immobilize the shoulder as it is possible to develop a frozen shoulder. However, some simple exercises should allow you to move the shoulder in a way that does not strain the rotator cuff, and allows inflammation to settle down.

2. Activity Modification

The way we lift our arm, carry objects, and sleep at night can all place strain on a rotator cuff. Learning proper ways to use the shoulder can place less strain on the rotator cuff muscles. The rotator cuff only accounts for four of the many muscles that surround the shoulder joint. Working with a physical therapist, you can learn to use the other muscles of the shoulder and rely less on the rotator cuff muscles.

3. Physical Therapy

Physical therapy is the most important step in the treatment of a rotator cuff injury. Strengthening the rotator cuff muscles is important to maintain normal shoulder function. A few meetings with a physical therapist can help teach you exercises to help alleviate and prevent a recurrence of your shoulder pain. The physical therapist can also try treatments to relieve pain and inflammation including ultrasound, electric stimulation, and other treatments.

4. Anti-Inflammatory Medications

Anti-inflammatory medications can be helpful at controlling the symptoms of a rotator cuff tear. Anti-inflammatory medications can be taken regularly for a short period of time, and then be used when symptoms of a rotator cuff tear flare-up. These medications should be taken only under the advice of your physician, but often they will adequately relieve the symptoms of a rotator cuff tear.

5. Ice Application

Ice can be applied to the shoulder to provide pain relief and to help settle down inflammation. Ice can be applied intermittently as well as after activities that cause shoulder pain. While ice packs can be easily made using household supplies, some people prefer ice wraps specifically made for the shoulder to provide a uniform cooling application to the shoulder.

6. Cortisone Injections

Cortisone injections can be incredibly helpful at limiting the acute inflammation of a rotator cuff tear and allowing the patient to begin therapy. It is important to participate in the therapy and exercises even if the shoulder feels better after an injection. While the cortisone can help settle the shoulder inflammation down, the therapeutic exercises of treatment will help prevent a recurrence of rotator cuff tear symptoms.

7. But Will Non-Surgical Treatments Work?

Non-surgical treatments can provide relief of symptoms of a rotator cuff tear in some, but not all, people. While different studies have found different rates of success, about 50% of people who try non-surgical treatments will find relief of symptoms. Some of the variables that can affect the likelihood of successful treatment include the size of the rotator cuff tear and the length of time you have been experiencing symptoms.

8. When Is Surgery Necessary?

Determining when surgery is necessary depends on several factors. Discuss with your doctor the particular reasons why surgery may be considered, or non-surgical treatments may be further attempted. As stated above, not all rotator cuff tears will need surgery for symptom relief.

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Sources:

Hawkins RH, Dunlop R: Non-operative treatment of rotator cuff tears. Clin Orthop Relat Res 1995;321:178-188.

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