Medications

Medicines don't heal rotator cuff disorders. They help with pain and inflammation. This allows you to start exercises to stretch and gradually strengthen the shoulder, which reduces the risk of stiffness or a frozen shoulder.

Medication choices

• Nonsteroidal anti-inflammatory drugs (NSAIDs). These are the most common medicines used to help manage rotator cuff disorders. NSAIDs are available with or without a prescription. Or you can use acetaminophen.
• Corticosteroid shots. These are strong medicines that are usually given only after 3 to 4 weeks of other treatment. If the first shot doesn't help much, a second shot may be given to make sure that the first shot was given in the right place. But there is rarely a need for more than a few shots.

Surgery

Surgery may be considered if:

• Your rotator cuff injury is very severe.
• You have severe pain and loss of shoulder function that haven't responded to other treatment.
• You have shoulder weakness caused by a complete tear, especially when the rotator cuff is otherwise healthy.

Surgery typically is used to repair a torn rotator cuff in a healthy young person, because good results are more likely if there is little or no evidence of other problems. People who have advanced rotator cuff disorders and tendons that are tough, stringy (fibrous), and stiff usually respond less well to surgery. Surgery may successfully repair the tear, but it can't repair all the damage caused by age or degeneration.

If surgery isn't done right away, repair of a large tear may not be as successful. But it still usually relieves pain and restores enough strength for you to do routine, nonstrenuous activities.

After surgery, a program of physical rehabilitation (rehab) is very important. You may not do as well after surgery if you aren't willing or able to commit to completing a difficult physical rehab program.

Rotator Cuff Problems: Should I Have Surgery?

Surgery choices

Shoulder surgery for rotator cuff disorders usually involves one or more of the following:

Debridement

Rotator cuff repair

Subacromial smoothing

These procedures may be done arthroscopically, by traditional open surgery, or by a combination of the two approaches.

Sometimes a rotator cuff tear is so severe that it can't be fixed in the usual ways. If this happens in a younger person, the doctor may suggest moving another tendon to substitute for the torn tendon. In an older person, the doctor may suggest a special shoulder replacement.

What to think about

The success of surgery for rotator cuff tears depends on many things, such as:

• The amount of other damage present.
• Your age.
• Other medical conditions. Some may cause you to heal slower.
• Your recovery goals and commitment to and compliance with a physical rehabilitation program.
• Whether you smoke. Smoking decreases the blood supply throughout the body and slows the healing process.