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.
In addition to the two types of rotator cuff injuries already mentioned - tear or tendonitis - you should be aware that there are other conditions that may exhibit similar symptoms. Be sure to see your doctor to get the right diagnosis. He or she will give you a physical examination and will probably inject your shoulder with a local anesthetic. These procedures help your doctor to determine exactly what is wrong with your shoulder. If your doctor believes that you have a rotator cuff tear, the next step may be imaging tests to confirm the diagnosis and find the exact location of the tear.
The more common diagnosis is rotator cuff tendonitis. Treatment for rotator cuff tears and rotator cuff tendonitis is quite similar. Both may be treated conservatively with rest, ice, compression and elevation (known as RICE) therapy. Additionally, an over-the-counter anti-inflammatory like ibuprofen is recommended. The physician may make a referral to a physical therapist for exercise therapy and modification methods that will help with ADL (activities of daily living). Persistent pain caused by tendonitis may be treated with local injections of a steroid/anesthetic mixture. This will help relieve pain in the joint.
Of the patients who use this non-surgical intervention, about half report having a decrease of pain and an increase in range-of-motion within six weeks to three months. Aside from efficacy, there are a number of advantages to non-invasive therapy. Surgical risks such as permanent stiffness, anesthesia complications, and infection can be completely avoided. With non-invasive therapy, there is no down-time for recovery. On the other hand, use of non-invasive techniques may cause an increase in the size of the tear. While there is not a recovery period, there may be a time period when the patient is able to do less. Of course there is also the chance that the non-invasive technique simply will not work. In this case, your doctor may recommend surgery. Your doctor may also recommend surgery if your injury is so severe that he or she feels a non-invasive approach would not be effective.
Click here for more on rotator cuff surgery .
Rotator cuff injuries can be treated surgically in three ways:
The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.
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.
Happily, rotator cuff surgery is a highly successful surgical procedure. Eighty to ninety-five percent of patients who have this type of surgery report successful results, improved range-of-motion and a significant decrease in pain in six months or less.
The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.
It is rare to experience complications with rotator cuff surgery. Tendon re-tear, which is the most commonly experienced complication, only occurs in about 6% of patients. One or two percent may have nerve injury. As little as one percent of patients may contract infection. Detachment of the deltoid muscle and/or stiffness are experienced by fewer than one percent of patients.
In addition to the two types of rotator cuff injuries already mentioned - tear or tendonitis - you should be aware that there are other conditions that may exhibit similar symptoms. Be sure to see your doctor to get the right diagnosis. He or she will give you a physical examination and will probably inject your shoulder with a local anesthetic. These procedures help your doctor to determine exactly what is wrong with your shoulder. If your doctor believes that you have a rotator cuff tear, the next step may be imaging tests to confirm the diagnosis and find the exact location of the tear.
The more common diagnosis is rotator cuff tendonitis. Treatment for rotator cuff tears and rotator cuff tendonitis is quite similar. Both may be treated conservatively with rest, ice, compression and elevation (known as RICE) therapy. Additionally, an over-the-counter anti-inflammatory like ibuprofen is recommended. The physician may make a referral to a physical therapist for exercise therapy and modification methods that will help with ADL (activities of daily living). Persistent pain caused by tendonitis may be treated with local injections of a steroid/anesthetic mixture. This will help relieve pain in the joint.
Of the patients who use this non-surgical intervention, about half report having a decrease of pain and an increase in range-of-motion within six weeks to three months. Aside from efficacy, there are a number of advantages to non-invasive therapy. Surgical risks such as permanent stiffness, anesthesia complications, and infection can be completely avoided. With non-invasive therapy, there is no down-time for recovery. On the other hand, use of non-invasive techniques may cause an increase in the size of the tear. While there is not a recovery period, there may be a time period when the patient is able to do less. Of course there is also the chance that the non-invasive technique simply will not work. In this case, your doctor may recommend surgery. Your doctor may also recommend surgery if your injury is so severe that he or she feels a non-invasive approach would not be effective.
Click here for more on rotator cuff surgery .
Rotator cuff injuries can be treated surgically in three ways:
The method that allows the surgeon to operate most freely is called open repair surgery. This method utilizes a full incision in the shoulder. This option can leave a rather large scar.
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.
Happily, rotator cuff surgery is a highly successful surgical procedure. Eighty to ninety-five percent of patients who have this type of surgery report successful results, improved range-of-motion and a significant decrease in pain in six months or less.
The expertise of the surgeon is a very important factor in the successful outcome of the surgery. However, there are some variables to keep in mind when considering speed and success of recovery. Among them are the type of tear, tissue quality, the patients age, and the amount the patient complies with the doctors instructions.
It is rare to experience complications with rotator cuff surgery. Tendon re-tear, which is the most commonly experienced complication, only occurs in about 6% of patients. One or two percent may have nerve injury. As little as one percent of patients may contract infection. Detachment of the deltoid muscle and/or stiffness are experienced by fewer than one percent of patients.
About the Author:
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, Vancouver SLAP Tears and Knee Doctors in Portland.
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