Should I consider surgery??

[domico]

Having a lot of pain in my shoulder for the past year. Had an MRI and below are the results:

Findings: No priors for comparison. No edema or atrophy within the rotator cuff muscles. High signal in the supraspinatus tendon at its insertion with a more focal area of hyperintense T2 signal suggesting tendinosis with a small partial bursal sided tear. The infraspinatus tendon and subscapularis tendon are intact. Intra and extra articular portions of biceps tendon are normal. Mild AC joint degenerative changes with a small amount of fluid in the subacromial/subdeltoid bursa. The labrum is intact. Marrow is normal in signal. No cartilage defects within the glenohumeral joint. Mild cystic changes in the posterior humeral head.

Impression: 1) Supraspinatus tendinosis with probable small partial bursal sided tear. 2) Mild AC joint degenerative changes and mild subacromial/subdeltoid bursitis.



Approx. one year ago I was having the same kind of pain in my other shoulder - had surgery and now that shoulder feels fine. Is surgery necessary in order to repair a small partial bursal sided tear? I am 50 yrs old.

Any suggestions would be appreciated.

[Heidi]

I would opt for conservative treatment first before you go down the road of surgery.

This should include massage to the supraspinatus muscle and frictions to the tendon as well as ultrasound to the tendon. Stretches for the supraspinatus can be found here:

http://www.sportsinjuryclinic.net/cybertherapist/stretching/allstretches.php

Once you have a full pain-free range of motion, strengthening can begin. Start isometrically (ie resisted abduction (lifting the arm out to the side) with no movement)

Strengthening should progress to using resistance bands to perform all shoulder movements and then free-weight exercises.

If having really given this kind of treatment a chance for 2-3 months and there is no real improvement, surgery may be the best option.