The rotator cuff is a group of four muscles that hold the upper arm bone in the shoulder socket and helps to turn and lift the arm. A rotator cuff tear can occur from an injury, or through overuse (from activities such as lifting). A partial rotator cuff tear can occur, as can a full-thickness tear, which is a split in the soft tissue. Symptoms include pain when lifting the arm on the affected side, pain while sleeping, particularly on the affected side, and loss of strength.
Diagnosing Rotator Cuff Tears
Physical Exam
Your physician will ask you a series of questions and is likely to do a physical exam. The physical exam will including examining any specific areas of concern, especially as they relate to the reason for your visit to the office.
X-Rays
A form of electromagnetic radiation with very high frequency and energy. X-rays are used to examine and make images of things such as the bones and organs inside the body.
MRI
This test uses a magnetic field, radiofrequency pulses, and a computer to produce detailed images of body structures in multiple places. You may be injected with a contrast agent for better imaging, and you will most likely lie on a moving table as pictures are taken. MRI is a more detailed tool than x-ray and ultrasound and for certain organs or areas of the body, it provides better images than CT. MRI may not be recommended if you have a pacemaker or other metal implants.
Treatments for Rotator Cuff Tears
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A class of medications, including but not limited to aspirin, naproxen, and ibuprofen, that are used for reducing pain and redness, swelling, and heat (inflammation) in arthritis and other painful inflammatory disorders.
Physical Therapy
Sometimes referred to simply as "PT," this is a type of rehabilitative treatment that uses specially designed exercises and equipment to help patients preserve, regain, or improve their physical abilities following injury, disability, disease, or surgery. Physical therapy can include therapeutic exercise, massage, assistive devices, and patient education and training.
Activity Modification
Physicians may prescribe general lifestyle changes to a patient, in order to help relieve the symptoms of their condition and improve their overall physical function and well-being. Depending on the medical condition being treated, activity modification may include: decreasing or increasing one's level of physical activity; added rest; beginning a new activity or exercise program; changing sleep habits; or modifying one's physical environment at home, in their vehicle, or at work.
Surgery for Rotator Cuff Tears
For patients whose symptoms, particularly their pain levels, do not improve with nonsurgical treatment methods over 6-12 months, their doctor may recommend surgery. Other surgical candidates include: those who need to use their arms to perform overhead work or a sport; those with a large rotator cuff tear (more than 3 cm); those with significant weakness and loss of function; or those with a tear caused by a recent, acute injury. Surgery to repair a torn rotator cuff most often involves re-attaching the tendon to the head of humerus (upper arm bone). There are a few options for repairing a rotator cuff tear, including open repair, all-arthroscopic repair, and mini-open repair. The patient's orthopedic surgeon will discuss the best procedure to meet each individual's health needs.