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The efficacy of conservative treatment in patients with full-thickness rotator cuff tears
Rotator cuff injuries are common, often resulting in chronic shoulder pain, weakness, and limited movement. Surgery tends to be the common solution. People are starting to investigate alternative treatments. A study titled “The efficacy of conservative treatment in patients with full-thickness rotator cuff tears,” explored the effectiveness of exercise supplemented with anti-inflammatory medication. The study was published on September 24, 2008 and is available through PubMed. Twenty patients with full-thickness rotator cuff tears were evaluated after six months of treatment. This study was the first to use an isokinetic devise to look at an objective measure of muscle strength in patients. Subjective measures were also used; after 6 months, 11 patients (55%) said that they were “much better” and 9 patients (45%) said that they were “better.” This study found that conservative treatment proved effective. There is some controversy, however. Other studies have found only slight improvement in shoulder function and comfort with conservative treatment, especially when looking at long-term results.
Previously, most clinicians advocated surgical treatment for torn rotator cuffs. Now, however, many people are starting to turn to conservative approaches, such as the one used in this study (oral non-steroidal anti-inflammatory medications paired with a three phase exercise program). Studies have shown that many people currently suffer from slightly torn rotator cuffs and do not even realize it. This would indicate that maybe surgery is not necessary. Just like any other operation, rotator cuff surgery is associated with many risks including infection, injury to nerves and blood vessels, stiffness of the joint, pain, the need for more surgeries, arrhythmias, and more. Also, even if you have rotator cuff surgery you may have to avoid sports or activities that require a throwing movement of your arm, such as baseball. Surgery can also be extremely expensive. Thus, a conservative alternative would allow people to save hundreds of thousands of dollars in medical bills. The positive results of this study compounded by the risks and cost of surgery suggest that conservative treatments should be a first line of defense in the treatment of full-thickness rotator cuff tears.
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