Of musculoskeletal injuries, rotator cuff injuries are one of the most frequent. A rotator cuff injury is quite painful and can cause shoulder weakness; however, it does not cause swelling. Interestingly, patients often do not have symptoms. Most of the time; however, the patient will experience pain and weakness during activities involving the arms. Raising the arm above shoulder level can prove particularly painful. On the bright side, there are quite a few ways to treat rotator cuff injuries. Your age and the type of injury you have will help determine which option will work best for you.
Rotator cuff injuries occur in two ways. You could either have rotator cuff tendonitis or a rotator cuff tear. It is important to realize that there are a few other conditions that can cause the type of pain one experiences with a rotator cuff injury. For an accurate diagnosis, you will need to see your physician. The first step your physician will take is a physical examination. Following the examination, your doctor may inject your injured shoulder with a local anesthetic. This process will help your doctor in determining exactly what kind of injury you have. If your doctor decides that you have a rotator cuff tear, he or she may send you for some imaging tests. Imaging tests will help pinpoint the location of the injury and confirm whether or not the injury is a tear.
It is far more common for the diagnosis to be rotator cuff tendonitis; however, the treatment for tears is very similar to the treatment for tendonitis. Both can be treated conservatively with what is known as RICE therapy. That is: rest, ice, compression, and elevation. You may also want to use an over-the-counter pain medication like ibuprofen. Additionally, your doctor may give you a referral to a physical therapist to learn how to modify your movements and to get a list of exercises that may be beneficial to you. If your tendonitis pain persists, your doctor may give you injections of a steroid/anesthetic mixture. These would be administered to the joint to relieve pain.
About half the patients using this kind of non-surgical treatment experience an increase in ROM (range of motion) and a decrease of pain within 2 or 3 months. This kind of treatment has several advantages. First of all, non-invasive treatment avoids surgical risks such as infection, anesthesia complications, and permanent stiffness. Second, there is no recovery time involved. Of course, there is also a downside in that this route could lead to an increase in the size of the tear. Additionally, the patients activity level may be decreased during the healing period. And, there is the risk that a non-invasive method may simply not work. If this is the case, and the non-invasive option fails, then surgery may be the alternative. The doctor may also decide that surgery is the better option if he or she feels that the injury is severe enough to merit it as the first option.
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When rotator cuff injury is treated with surgery, there are generally three options.
The first way is open repair surgery. When open repair surgery is chosen, the surgeon will make a full incision into the shoulder. This large incision has the potential of leaving a large scar; however, this method allows the surgeon to have a great deal of freedom of movement.
Another method that utilizes both an incision and arthroscopy is called mini-open repair surgery. This is an outpatient procedure in which the surgeon makes a smaller incision and uses an arthroscope to see the interior of the shoulder structure. This procedure leaves a much smaller scar.
3. All arthroscopic surgery: This option is an outpatient procedure, and it uses the smallest incision.
Your doctor will need to give you a thorough examination and do complete testing to determine which type of surgery will be best in your case.
The majority of patients who have rotator cuff surgery experience a decrease in pain and an increase in ROM (range of motion) within four to six months following surgery. In fact, eighty to ninety-five percent of people who have this surgery report satisfaction with the results.
The success of your recovery is dependent on a number of factors. Among them are, your surgeons level of expertise, your fitness level, the severity of your injury, and your compliance with your doctors instructions.
Some patients experience complications from surgery; however, these are rare. One to two percent may experience nerve injury. Approximately one percent may contract infection. Less than one percent may have detachment of the deltoid muscle. Less than one percent may experience stiffness. Tendon re-tear is experienced by approximately six percent of patients.
Dr. Edelson is a Board Certified Orthopaedic Surgeon specializing in sports medicine. His clinic, Sports Medicine Oregon, focuses on athletes of all ages. Click here to learn more about Dr. Edelson, Bicep Repair in Oregon and Portland Bicep Surgery.