Rotator Cuff Tear - Is Surgery The Only Option?

Shoulder pain is a common complaint treated by chiropractors and physical therapists. Daily stresses, trauma, and overuse are a few factors that lead to the development of pain. I frequently have patients discuss their torn rotator cuff as their pain generator based on an MRI finding, but is this true? Perhaps.

The rotator cuff is made up of primarily four muscles that act to move your arm in all directions. When one of these muscles becomes injured or torn, one or several specific movements can become painful and is typically relieved with rest.

Interestingly, there is a lot of research going on looking at management of potential rotator cuff injuries. One study in particular suggested patients with shoulder pain and a diagnosed rotator cuff tear accounted for 35% of the population, while 65% of those studied had tears in the rotator cuff but demonstrated no symptoms (Minagawa, H et, al. 2013).

So, what might these numbers suggest?

Many people living an active lifestyle probably have rotator cuff tears but no symptoms and no daily activities affected. Therefore, if one of these people had a sore shoulder for a week or two and received an MRI, they may be considered surgical candidates (even though the torn tissue may not be causing the pain). As clinicians, we must keep in mind many factors go into being a surgical candidate (age, occupation, level of daily activity, severity of pain, functional loss, etc.).

Overall, it is important to understand that shoulder pain may be due to many causes and there are multiple treatment options available. Pain may be perceived for multiple reasons, with or without structural damage that an MRI could pick up. If you are or you know someone suffering with acute or chronic shoulder pain, find a chiropractor or physical therapist near you knowledgeable in the rehabilitation of shoulder injuries!

Minagawa, H (et, al.). 2013. Prevalence of symptomatic and asymptomatic rotator cuff tears in the general population: From mass-screening in one village. Journal Of Orthopaedics. 10: 8-12 .