Article featured on Arkansas Surgical Hospital
Rotator cuff tears are intensely painful injuries to the rotator cuff area, which is a group of muscles in the shoulder that allows you to make a wide range of movements. While a minor rotator cuff tear can be treated in various ways, a severely torn rotator cuff often requires surgery for a full recovery.
Most rotator cuff tears result from a single incident, such as a sports accident, a fall, or lifting something that’s too heavy. Sometimes, a tear can result from a bone spur in the shoulder. Rotator cuff tears are also prevalent in individuals who use repetitive motions, such as lifting boxes or reaching above their heads. For example, construction workers and delivery people often develop rotator cuff tears after years of overusing their shoulder joints.
Symptoms of a Torn Rotator Cuff Pain
The first and most noticeable sign of a rotator cuff tear is pain that can be excruciating. The pain will cover a large area, including the outside of your shoulder and upper arm. The discomfort increases when you lift your arm over your head and is usually worse when you’re trying to sleep. Because nerves run down the arm from the rotator cuff, some patients experience pain as far down as their elbow. A constant, dull throbbing or ache in the shoulder is also common.
If the rotator cuff is torn, it will be difficult to move your arm and shoulder normally. Simple activities like brushing your hair, getting dressed, and preparing food will cause a great deal of pain. Carrying even small items may be difficult because you don’t have a full range of motion.
Your shoulder becomes stiff and tender when you have a torn rotator cuff. If you stop moving your arm, the area will become even more inflexible. This complicates the situation since movement is painful but not moving the joint can lead to a stiff or frozen shoulder.
When your rotator cuff is torn, your shoulder can’t support as much weight as it normally does. Lifting something even as light as a book or a mug of coffee may be difficult. Your grip may be weak, making it difficult to keep hold of things.
Treatment Options for a Torn Rotator Cuff
Rest, Ice, & Physical Therapy
If the tear is minimal, resting the area and periodically icing it to reduce the inflammation may be helpful. Doctors usually combine this method with physical therapy to promote movement and keep the area from stiffening and impacting your range of motion. After several days, ice may be alternated with heat to improve blood flow. Patients may want to use a sling to support the shoulder and minimize discomfort when they’re not in physical therapy. In addition, over-the-counter pain medications can alleviate shoulder pain.
For intense pain, steroid injections into the joint near the tear can reduce swelling and help you rest comfortably. These injections provide temporary relief so you can continue with physical therapy and sleep better. However, using them for too long or at high doses should be avoided to minimize the risk of weakening the damaged tendon.
Rotator Cuff Surgery
There are several surgical options for rotator cuff tears. And if the injury is severe enough, surgery may be the only option.
Your physician can help you determine whether surgery is the best option for you. If you have to use your arms to lift or reach over your head for work or sports, surgery may be a good idea. Other indications that rotator cuff repair surgery may be the right choice for you include:
- Pain that has lasted at least 6 months
- A tear resulting from an acute injury
- A tear larger than 3 centimeters in an otherwise healthy tendon
- Weakness, loss of function, or a limited range of motion that lasts several months
Types of Surgery for Rotator Cuff Tears
Partial Rotator Cuff Repair
A partial rotator cuff repair is performed when the tendon is torn but hasn’t fully detached from the underlying bone. Part of the acromion bone—which is located on the scapula, or shoulder blade—is removed during the procedure. This gives the rotator cuff more room for movement.
Arthroscopic surgery is then performed to removed the inflamed bursa sac and smooth the frayed ends of the torn tendon. If needed, a damaged ligament may also be removed. This procedure is done through small incisions on the side and back of the shoulder.
Full Rotator Cuff Repair
A full rotator cuff repair surgery is needed if the tendon has torn through completely or is completely detached from the humerus, or upper arm bone. A full rotator cuff repair may be performed in a few different ways based on the extent of the damage.
- Arthroscopic surgery: Small incisions are made in the back and side of the shoulder, debris is flushed out with a saline solution, and the surgeon removes any damage such as bone spurs. Then, the tendon is reattached the humerus with suture anchors.
- Open surgery: This is done only in cases of severe joint degeneration or severe injury. Bone and tissue grafts from other areas of the body are used to replace damaged bone, cartilage, and tendons. The tendon is then reattached to the head of the humerus bone.
- Mini-open surgery: This “in-between” option is sometimes done if the surgeon needs a larger incision than is used in arthroscopic surgery, but grafts or opening the entire shoulder joint aren’t required.
Get Help for Your Torn Rotator Cuff
If shoulder pain and limited movement impact your daily life, it’s essential to see a doctor who’s familiar with the treatment options for rotator cuff tears.
Physicians will use x-rays, MRIs, arthroscopy, and other tools, combined with a physical exam, to determine the extent of the damage and advise you on your treatment options.
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