There are a number of possible treatments for rotator cuff injuries, depending on how serious the injury is and what the tendon quality is like.
The treatment of a tear that has occurred directly from injury (acute) may need quicker treatment or repair, with best results seen if tendons are repaired within a few months of the injury. However, chronic tears may not need repair.
The size of the tear may not relate to the degree of pain or the need for treatment and expert guidance can help clarify options for a condition where management can be confusing.
If the tear is relatively minor (minimal pain and good function), you may benefit from:
- Painkillers and anti-inflammatories.
- An exercise program to help increase the range of motion in your shoulder and improve muscle strength and flexibility. This may be guided by physiotherapists.
- Injections of corticosteroids into the joint to relieve pain and reduce inflammation in the short-term.
For more serious tear, some of the treatments may be important but you may also require surgery. There are a number of possible approaches, including:
- Arthroscopy – this is a minimally invasive (keyhole) surgical procedure to repair the affected tendon. It involves making a small incision in the skin and inserting an arthroscope, which is a tiny, flexible tube with a camera at one end that allows the surgeon to see inside the joint. Tiny surgical tools are inserted through further incisions in the skin and used to reattach torn tendons to the bone.
- Open surgery – to reattach damaged tendons to the bone when this cannot be achieved keyhole.
- Tendon grafts – these are false tendons used to replace or reinforce damaged areas. They may be derived from human donor skin which allows the most ‘biological’ healing.
- Tendon transfer involves using a tendon from another part of the body to replace the damaged rotator cuff.
- Joint replacement surgery may be required if there is substantial damage to the rotator cuff that cannot be repaired. Reverse shoulder arthroplasty involves creating a ball joint within the shoulder blade and a socket in the arm bone to improve movement and flexibility.