Rotator cuff problems are quite common, with nearly 2 million people in the U.S. visiting a doctor each year for rotator cuff tears. However, not all of these injuries require surgery. It’s up to you and your doctor to decide when not to have rotator cuff surgery.
Indications Against Rotator Cuff Surgery
Following are some signs that can help you decide whether you need the surgery or not:
- Mild or No Symptoms: People with rotator cuff tears who have little to no pain or movement problems can often manage without surgery using treatments like physical therapy and rest.
- Improvement with Non-Surgical Treatments: If symptoms improve with options like medication or physical therapy, and there’s no ongoing pain or weakness, surgery may not be needed.
- Small Tears: Smaller tears that don’t interfere much with shoulder function or daily tasks usually don’t require surgery, especially for people with low physical activity levels.
- Age and Health Factors: Older adults or those with health conditions that make surgery risky may avoid it if the tear doesn’t greatly affect their quality of life.
- Personal Choice: Some people prefer to skip surgery due to concerns about recovery and potential risks or want to try all non-surgical options first.
When to Have Rotator Cuff Surgery?
Rotator cuff surgery is usually recommended in the following situations:
- Ongoing Pain: If shoulder pain lasts for 3-4 months despite treatments like physical therapy or anti-inflammatory medications, surgery may help relieve discomfort and improve function.
- Loss of Function: Surgery may be needed if there’s significant weakness or difficulty using the shoulder for daily activities or sports, especially if the tear is complete or from a recent injury.
- Large Tears: Tears larger than 3 cm with healthy surrounding tissue are more likely to benefit from surgery, particularly if symptoms have lasted 6-12 months.
- Recent Injuries: Rotator cuff tears caused by recent injuries often need surgery to fully restore shoulder function.
- Night Pain: Pain that disrupts sleep may signal a more serious issue that conservative treatments can’t fix, making surgery a possible solution.
What Percentage of Rotator Cuff Tears Require Surgery?
Only about 10-20% of rotator cuff tears need surgery, as most people manage well with treatments like physical therapy. Many with partial tears or mild symptoms find relief without surgery, showing that most rotator cuff injuries don’t require surgical repair.
When Is It Too Late for Rotator Cuff Surgery?
If a rotator cuff tear isn’t treated, it can grow larger over time. Eventually, the tendon can completely break down, the muscle may turn into fat, and the shoulder joint may stop working properly. At this point, it’s no longer possible to repair the rotator cuff with stitches.
Wrapping Up
In the end, your doctor is the best person to decide when not to have rotator cuff surgery. Therefore, you must discuss your symptoms and any other concerns openly.
Visit our board-certified orthopedic surgeon, Dr. Gombera, at Mufaddal M. Gombera, MD. Our surgeon specializes in sports medicine, arthroscopy, and treating shoulder, hip, and knee injuries. Dial (713) 794-3457 to book a consultation.
