Rotator Cuff Tear
The Rotator cuff tear is a common shoulder injury caused by lifting heavy objects regularly or due to aging and degeneration. The Rotatorcuff disease presents with wide variety of symptoms , some times it can be a silent problem with no pain or mild discomfort in the shoulder and in some group of patients it presents like a pseudoparalytic condition with extreme pain and inability to move the shoulder .
The main goal of any treatment method has to be the reduction of this pain and the restoration of the shoulder’s functionality. The doctor will devise a treatment plan according to the patient’s age, health condition, activity level and the type of tear. The doctors usually would initially try non-surgical treatment and would opt for surgical methods if the condition does not improve through non-surgical methods.
Why is it done?
This method of non-surgery is advised for very small tears or irreparable tears where strengthening the muscle around the shoulder girdle has proven to provide comfort and improvement in the shoulder’s functionality in some of the patients But non-surgical treatments have the following disadvantages:
- Chances of the tear increasing over time
- Limited activities due to the restriction of the shoulder’s movement.
Non Surgical Treatments
- Rest: The doctor would recommend resting and limited overhead activities and usually the doctor might prescribe a sling to protect the shoulder and keep it stationary.
- Modify Activity: The doctor might suggest avoiding certain actions and activities to prevent shoulder pain.
- Non-Steroid Anti-Inflammatory Medication: Medications like Acetaminophen, Ibuprofen and Naproxen are prescribed by the doctor to relieve pain and reduce swelling.
- Physical Therapy: The doctor might also suggest physical therapy and certain exercises for strengthening shoulder muscles, restore movement, improve the flexibility and range of motion. These exercises will help the shoulder to relieve pain and also prevent further shoulder injury.
- Steroid Treatment: The doctors might include steroid injections as part of the treatment plan if resting, medications and exercises do not relieve the pain. This injection is a combination of a local anesthetic and cortisone, an anti-inflammatory medicine.
- Stem Cell Treatment: This is an alternative treatment method for rotator cuff tears. In this approach, the stem cells are extracted from an area of higher density and then harvested and then re-injected into the damaged area to help the natural healing process.
Surgical Treatment Method For Rotator Cuff Tear
The surgical method is usually suggested by the doctor when the patient has continuing pain even after following other treatments. The other signs that recommend this method are:
- Long standing pain and difficulty in shoulder related activities
- If the tear is a large one and the surrounding tissues are good
- Significant weakness and loss of functionality of shoulder
- Tear caused by acute injury
The main purpose of surgery involves the re-attachment of tendon to the upper arm bone. The two main options for surgical treatment are:
- Shoulder Arthroscopy: This is a minimally invasive surgery that is performed to diagnose and treat shoulder injuries like Rotator cuff tear. This surgical method will help in diagnosing the injury and repair of the ligaments with minimum risk. It involves the use of a tiny camera called Arthroscope that will help view inside of the joint and analyze the extent of the injury and correct it. This is the current standard mode of treatment all across the globe as literally any tear can be repaired with arthroscopy and healing is faster.
- Open Surgery: This is the traditional approach where an open incision, usually large, is required to treat the injury. The incision is made over the shoulder and shoulder muscles are detached and bone spurs are removed. This type of surgery is less recommended due to the advantages of arthroscopy over open surgery.