Pain Management and Pain Relief Information

Arthroscopic rotator cuff surgery has been very successful in treating the common shoulder injury known as a rotator cuff tear. A tear to the rotator cuff can occur from traumatic shoulder impact, repetitive heavy lifting, strong pull, or years of bone spurs rubbing against the shoulder tendon. When this shoulder injury happens, the cuff muscles essentially tear off the humerus bone. A simple definition of the rotator cuff is a group of tendons and muscles that connects the humurus and scapula facilitating over head motions. Surgical and non surgical approaches are used to treat this common shoulder injury.

Symptoms of this shoulder injury include pain on outer side of arm, loss of shoulder mobility, shoulder pain while trying to sleep, and weakness lifting arm overhead. This injury is common in sports and activities involving repetitive arm motion. Shoulders are a very complex joint involving multiple muscle groups, joints, and nerves. The rotator cuff is made up of four different tendons and muscles that coordinate arm movement at the shoulder joint. These cuff muscles are responsible for shoulder rotation and maintaining proper alignment by securing the shoulders in the socket. During shoulder movement, cuff muscles are the stabilizers and help properly position the humeral head and scapula.

The overall severity of this injury can vary. Mild strains with some cuff inflammation often results into no permanent damage and doesn’t require surgery. However, partial or complete tears to these muscles and tendons could progressively get worse if left untreated. A partial rotator cuff tear happens when the cuff muscle continously rubs against bone spurs. Partial tears commonly lead to complete ruptures after years of repetitive contact with bone spurs. One basic strategy used by shoulder surgeons for this injury is the removal of bone spurs if necessary and cleaning up the inflamed tissue.

Arthroscopic rotator cuff surgery involves removing bone spurs that are pushing against the cuff and reattaching the tendon to the humurus bone. Shoulder surgeons can repair this injury arthroscopically which is a lot less trauma to the patient, little scarring (three or four small holes), and less discomfort. Surgery is performed as an outpatient so returning home the same day is standard protocol.

Orthopedic surgeons can examine the inside of the shoulder using the small surgical camera (arthroscope) and analyze the tear and even “clean up” inflamed tissue and bone spurs. This style of surgery is referred to as being minimally invasive. The surgical tools are inserted into the shoulder through three or four small holes and everything is viewed on a TV monitor that’s also being digitally recorded. Sutures and rivets are used to reattach the rotator cuff if a tear is discovered.

Following arthroscopic rotator cuff surgery patients will go through a well planned out four phase recovery. The first six weeks is a passive motion only phase were patients can not put any tension on the repair. No lifting of the arm for the first four to six weeks. Phase two is about active shoulder motion meaning only arm movement without resistance. The active motion phase lasts up to twelve weeks following surgery. Phase three of recovery is the strengthening phase in which light weight lifting and resistance band exercises begin. Full recovery (phase four) and getting back to your previous level of activities can take five to six months or longer. Your physical therapist will let you know when to progress to the next phase of recovery. Key determining factors on a speedy recovery are dedication to physical therapy, size of the tear, patients ability to heal, and experience of the shoulder surgeon doing the rotator cuff surgery.