Rotator Cuff Tear Treatment in Delhi, India

There are two types of torn rotator cuffs. These include:

• Partial tears: The tendon is still attached to the bone with an incomplete tear.
• Complete tears: The tendon separates from the bone with complete tears. There is a proper rip between the muscles.

People with rotator cuff injuries experience immense pain in the shoulder. They often describe it as a dull pain that disturbs sleep. Further, moving the arm backwards to work behind the back is difficult. It often leads to weakness in the arms.

Even though most rotator cuff injuries are painful, some patients feel no pain. However, sudden tearing of rotator cuffs leads to immediate and intense pain.

Some rotator cuff injuries are painless or cause mild pain. For example, degenerative diseases cause mild pain that is manageable with over-the-counter pain medicines. However, the pain worsens with time. Some signs associated with a rotator cuff tear are:

• Difficulty and pain while raising the arm.
• Shoulder weakness
• Popping or clicking sounds or sensations on moving the arm.
• Shoulder pain that often worsens at bedtime or middle of the night.
• Difficult to lift items

Significant injuries to the shoulder often cause rotator cuff tears. These include accidents or falls that lead to a broken collarbone or shoulder dislocation. This also occurs with time due to the wearing of the tendons as a person ages. This type is termed degenerative tear. Some causes are:

• Bone spurs: Bony projections developing due to calcium deposits along the edges of the bone are called bone spurs. They form at the junction of two bones or on the bones of the spine. They commonly occur as a result of osteoarthritis. However, most of them are asymptomatic and may remain undiagnosed for years.
• Decreased blood flow: When blood flow to the rotator cuff decreases, they may not get the nutrition they need to perform their function and eventually weaken with age. Hence, they are more prone to tears.
• Overuse: Repetitive shoulder movements without proper rest lead to rotator cuff tears. This primarily occurs during sports or on the job.
• Occupation-related tear: Certain occupations, such as painting and carpentry, require repetitive hand movements that stress the muscles and tendons, causing a tear.

Doctors often perform a physical exam and press on different parts of the affected shoulder. They also assess the movement of the arm in different directions. In addition, they test muscle strength around the shoulder and arms.

Some imaging tests that they may advise are:

• X-rays: Although rotator cuff tears don't appear on X-rays, this test helps evaluate bone spurs or other potential causes of pain—for example, arthritis.
• Ultrasound: The ultrasound test produces sharp images of the body organs. This test provides clear images of soft tissues like muscles and tendons. It thus allows the doctor to evaluate the structures of the shoulder during movement.
• Magnetic resonance imaging (MRI): MRI uses radio waves and a strong magnet to give detailed images of the inner body systems. This test makes it easy to assess the shoulder joint and muscle tear.

Rotator cuff tears often require immediate medical care. Hence, it is advisable to visit the emergency care department immediately if such an injury is experienced. Some treatment options are:

Non-surgical Treatment

Rotator cuff tears need surgery to fix the tear and enhance arm movement. However, many patients improve functionally with lesser pain with some non-surgical remedies. Strengthening the shoulder muscles helps with recovery. However, this does not imply that surgery can be avoided.

8/10 people with a rotator cuff tear can avoid surgical intervention if the tear is minor. It can take up to a year to see significant improvements. Some non-surgical options are:

• An arm sling and rest: The arm sling prevents shoulder movement and allows it to heal. Modifying activities and avoiding work or sports also help with healing.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): These help manage pain.
• Physical therapy: This therapy strengthens muscles and increases the arm's range of motion.
• Steroid injections: Steroids help reduce pain and swelling if the pain is unbearable.
• The application of ice also eases pain and swelling.

Surgical Treatment

Surgeries are often advised to restore muscle function and reduce pain. Some surgical options available for rotator cuff injuries include:

• Arthroscopic tendon repair: With the help of an arthroscope inserted through small incisions, the tendon is reattached to the bone.
• Open tendon repair: An open surgery to repair the tendon is sometimes necessary. A larger incision is made to access the tear and repair it.
• Tendon transfer: When torn tendons cannot be reattached, another nearby tendon may be used as a replacement.
• Shoulder replacement: Major rotator cuff tears may warrant shoulder replacement surgery. This allows for improved artificial joint stability.

The following factors contribute to the risk of developing a rotator cuff injury:

• Age: As people age, the risk of a rotator cuff injury increases. It is common in people over the age of 50.
• Some occupations: Certain occupations, such as painting and carpentry, require repetitive hand movements that stress the muscles and tendons, causing a tear.
• Certain sports: Some sports, such as baseball, tennis and weight-lifting, may cause rotator cuff injuries.
• Family history: Some cases show involvement of a genetic component with rotator cuff injuries. This is because this injury appears to occur more commonly in certain families.
• Degenerative tears

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