People who are middle-aged or older often tear their shoulder rotator cuff while lifting or doing something as simple as reaching out too fast or bracing to prevent a fall. Surgery seems to be the definitive treatment, but recent studies disclose that whether a patient reports success from the surgery has nothing to do with whether the rotator cuff tendon heals or does not heal.

The shoulder rotator cuff is a collection of muscles that stabilize the ball in the socket of the shoulder joint and help you to lift your arm. As we age, trauma can lead to a tear in one or more of the muscles or tendons of this complex. A patient with a torn rotator cuff often experiences shoulder pain. It would make sense that if the rotator cuff is torn, then surgically repairing it by sewing it back together should eliminate the pain. It also would make sense that if the pain was being caused by the torn rotator cuff, then patients who showed healing of the tears after surgery should also report better outcomes than those who didn’t show healing.

Such sensible reasoning is behind the practice of surgically repairing torn rotator cuffs.  A report in the May 2015 issue of The American Journal of Sports Medicine—and seen across several other studies—calls the validity of rotator cuff surgery into question by showing that whether a patient reports that the surgery is successful has nothing to do with whether the rotator cuff tendon heals.

Since torn rotator cuffs are common in patients without shoulder pain, it’s not an automatic conclusion that a torn rotator cuff is to blame in all cases of patients reporting shoulder pain—even if MRI indicates a tear in the patient’s rotator cuff. An alternative cause of shoulder pain might be pinched nerves in the neck.

Regenerative medicine offers a non-surgical option for treating a torn rotator cuff using an injection of the patient’s own stem cells.

“The Dirty Little Secret of Rotator Cuff Surgery” first appeared as a post on the Regenexx blog.

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