Does a Torn Rotator Cuff Always Require Surgery?
Two million people suffer rotator cuff tears yearly. Some get surgery, but is it always necessary? Learn the answer to this question, how your shoulder works, and why this injury is so limiting, here.
Your shoulder is killing you, but is it tendinitis or bursitis? You may have heard of these two common afflictions that cause shoulder pain, and though they share characteristics and the terms are often used interchangeably, they’re actually distinct conditions.
We’ll cover how the conditions overlap and differ, and most importantly, what can be done to relieve the pain and mobility limitations they both cause.
Dr. Struan Coleman approaches every patient he treats armed with years of experience and clinical expertise in treating many conditions. Importantly, he understands that every patient is different. His personalized treatment plans take into account a patient’s medical history, their current challenges, and the goals they’d like their treatment to meet.
Let’s look at what tendinitis and bursitis have in common. Both are rotator cuff conditions that develop when the soft tissue around your muscles and bones becomes inflamed. The rotator cuff is made up of muscles and tendons that keep the head of your humerus (the upper arm bone) in the shoulder socket, enabling you to rotate your arms and raise them.
The big difference between shoulder tendinitis and bursitis, however, is the type of tissue that’s impacted by the inflammation.
Tendons are thick tissue bands that connect muscle to bone and help your bones move. The bursa is a sac filled with fluid whose purpose is to act as a protective cushion between your bones and tendons or muscles that envelop your bone.
The bursa prevents your bones from experiencing too much friction when they rub against each other. Bursitis is when the bursa becomes inflamed, and you’ll also hear it referred to as impingement syndrome.
Overuse and traumatic injury are the most commonly seen causes of shoulder bursitis, while tendinitis frequently develops because a tendon is being compressed somehow. Dr. Coleman often sees shoulder tendinitis in patients who habitually play sports that require them to move their arms over their heads a lot, like baseball and volleyball.
When Dr. Coleman makes a diagnosis of either shoulder tendinitis or bursitis, the first thing he does is inquire in detail about the symptoms you’re experiencing.
If you complain of shoulder pain, particularly at night, and problems holding your arm in some positions, he suspects tendinitis.
Should you mention that your shoulder pain started after an injury, however, he may think the problem is bursitis. The inflammation that’s fueled by the injury thickens your tendons and bursa, and then they’re pinched by this compression. This is often the beginning of a repetitive cycle of inflammation and tendon and bursa thickening that leads to more pain.
Bursitis can also be caused by overuse and conditions like arthritis, diabetes, and thyroid disease.
With both conditions, Dr. Coleman starts out with conservative treatments, after doing imaging tests that allow him to have a closer look at the cause of your shoulder pain. He may recommend:
Sometimes these treatments aren’t enough to get true and lasting relief, however. If you try them and are still left with shoulder pain, inflammation, and mobility problems, Dr. Coleman may recommend minimally invasive arthroscopic surgery.
During this two-part procedure, Dr. Coleman evaluates your shoulder problem and damage, and then he makes repairs. He uses a tool called an arthroscope (a fiber optic camera mounted on a narrow, bendable tube) that enables him to perform surgery through several small incisions, unlike traditional open surgery, where the surgeon makes a single long incision.
These minimally invasive procedures are associated with faster recovery and less pain, bleeding, and scarring. You typically return home on the same day as well.
If you suffer with shoulder bursitis, Dr. Coleman may remove the bursa, part of the bone, and bone spurs to provide more room for your rotator cuff tendons.
If you have severe tendinitis that’s made your rotator cuff tendon tear, Dr. Coleman can reattach your torn tendon to the top of your humerus. If necessary, he can remove loose pieces of bursa, tendon, and scar tissue. He may also remove bone spurs or shave away bone to make room so your rotator cuff and bones can move more easily.
Whether you’re found to have shoulder bursitis or tendinitis, you're in the best care with Dr. Coleman and his outstanding, caring team. Call our Sunset Park, Locust Valley, or Philadelphia office to schedule an appointment, or reach out to us through our website.
