When Does a Rotator Cuff Injury Require Surgery?

Rotator cuff tears are common injuries, affecting nearly two million people each year in the United States. These full or partial tears affect a group of tendons and muscles in your shoulder joint responsible for securing the upper arm bone in its socket. 

Rotator cuff tears occur when tendons pull away from the bone. After a partial tear, your tendon is still partly attached to your arm bone, while full-thickness (complete) tears cause tendons to separate fully from the bone. Sometimes surgery is needed to reattach a torn rotator cuff, while other times conservative treatments ease your discomfort long-term. 

Visit with our pain management specialists at Integrated Pain Consultants for an evaluation if you have ongoing or severe shoulder pain — or have obvious signs of an injury. 

Symptoms of rotator cuff tears

Rotator cuff tears can cause the following symptoms:

• Difficulty moving or raising your arm
• Shoulder pain and weakness
• Difficulty sleeping on the affected side
• Problems reaching behind your back
• Dull, aching discomfort
• Pain that worsens when resting your arm
• Discomfort at night
• Difficulty lifting items
• Stabbing shoulder discomfort
• Clicking, cracking, or popping sounds when moving your arm

Your discomfort might begin as mild (barely noticeable), only appearing when lifting your arm over your head. But this pain can worsen over time if your injury is left untreated. 

Common causes of rotator cuff tears include falls, playing sports, repetitive shoulder movements (overuse), bone spurs, and age-related wear. 

Signs you may need shoulder surgery

Shoulder surgery is often a last resort, only used after first trying conservative options. You may be a candidate for rotator cuff surgery if:

Conservative treatments haven’t worked

Conservative treatments our pain management specialists may recommend before considering surgery include rest, an arm sling, modified physical activity, anti-inflammatory medications, chiropractic manipulation, joint injections, or physical therapy. If these haven’t worked as a first line of defense and you need more relief, rotator cuff surgery may be the solution for you. 

While rotator cuff tears require surgery for complete repair, you’ll often have less pain and improved functionality with nonsurgical methods. About 80% of people with partial tears improve without surgery, though it might take up to 12 months to achieve optimal results. 

You’ve sustained a severe injury

More severe rotator cuff injuries, including complete tears, may warrant shoulder surgery. This is particularly true if you have significantly reduced shoulder function that negatively impacts your quality of life.

To determine the extent of a shoulder injury, our caring specialists complete a physical exam, discuss your symptoms, and order imaging procedures — such as an MRI or ultrasound. We’re typically more likely to recommend surgery if your tear is greater than three centimeters in size and the surrounding tissues are of good quality. 

You suffer from ongoing discomfort

Ongoing shoulder pain is generally an indication for surgery, particularly if your symptoms have lasted 6-12 months (or longer). Our pain management experts discuss your treatment options and tailor a plan based on the severity of your injury, your symptoms, and your lifestyle goals.

Your job requires fully functional shoulder strength

While some people with partial tears live fully functional lives without surgery, you might opt for surgery if your job requires maximum shoulder functionality. For example, athletes, construction workers, painters, or mechanics may choose surgery and a full recovery to efficiently complete their job duties or sports performance.

Find out if rotator cuff surgery is right for you by scheduling an evaluation at Integrated Pain Consultants by phone or requesting an appointment online today.