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.
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The rotator cuff is a group of four
The
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:
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
There are two types of surgery for rotator cuff disorders. They help improve strength and movement, and they also relieve pain.
Surgery may be a good choice for you if both of the following are true:
Sudden tears, such as from a major sports injury or car accident, 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.
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:
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 physical therapy 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 physical therapy. You need to complete a physical therapy program to have a full recovery after surgery.
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:
After you try rest and gentle movement, physical therapy may help relieve your pain and restore strength and flexibility in weak and stiff shoulders. Physical therapy includes exercises to:
You may not need surgery if:
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.
Your doctor may recommend rotator cuff surgery if:
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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.
Patty, age 27
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 physical therapy, 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 physical therapy. I think I can manage a long-term rehab program.
Jennifer, age 47
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 physical therapy 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.
Dan, age 67
Every time I move my shoulder a certain way, it's really painful. My range of motion has gotten better with physical therapy, 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 physical therapy for a long time still. But we agree that the surgery is reasonable to help that specific problem.
Kwame, age 49
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 physical therapy will help me regain the use of my shoulder faster.
I don't mind waiting longer while I try rest and physical therapy to heal my shoulder.
The cost of surgery doesn't bother me.
I'm worried about the costs of surgery.
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.
The benefits of surgery outweigh the risks for me.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
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
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
Author | |
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Clinical Review Board | All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
The rotator cuff is a group of four
The
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:
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
There are two types of surgery for rotator cuff disorders. They help improve strength and movement, and they also relieve pain.
Surgery may be a good choice for you if both of the following are true:
Sudden tears, such as from a major sports injury or car accident, 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.
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:
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 physical therapy 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 physical therapy. You need to complete a physical therapy program to have a full recovery after surgery.
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:
After you try rest and gentle movement, physical therapy may help relieve your pain and restore strength and flexibility in weak and stiff shoulders. Physical therapy includes exercises to:
You may not need surgery if:
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.
Your doctor may recommend rotator cuff surgery if:
Have rotator cuff surgery | Try other treatment | |
---|---|---|
What is usually involved? |
|
|
What are the benefits? |
|
|
What are the risks and side effects? |
|
|
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."
— Patty, age 27
"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 physical therapy, 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 physical therapy. I think I can manage a long-term rehab program."
— Jennifer, age 47
"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 physical therapy 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."
— Dan, age 67
"Every time I move my shoulder a certain way, it's really painful. My range of motion has gotten better with physical therapy, 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 physical therapy for a long time still. But we agree that the surgery is reasonable to help that specific problem."
— Kwame, age 49
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 physical therapy will help me regain the use of my shoulder faster.
I don't mind waiting longer while I try rest and physical therapy to heal my shoulder.
The cost of surgery doesn't bother me.
I'm worried about the costs of surgery.
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.
The benefits of surgery outweigh the risks for me.
I don't want to have surgery for any reason.
My other important reasons:
My other important reasons:
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
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. Can you limit rotator cuff damage by trying to treat it without surgery?
3. Is surgery a good choice if you still have symptoms after 6 months of rest and physical therapy?
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?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
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Clinical Review Board | All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals. |
Current as of: July 17, 2023
Author:
All Healthwise education is reviewed by a team that includes physicians, nurses, advanced practitioners, registered dieticians, and other healthcare professionals.
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