Rotator cuff tear oxidative stress induces tenocyte apoptosis causing further rotator cuff tendon degeneration. A neural theory also exists that suggests neural overstimulation leads to the recruitment of inflammatory cells and may also contribute to tendon degeneration. Tears of the rotator cuff tendon are described as partial or full thickness, and full thickness with complete detachment of the tendons from bone. Shoulder pain is variable and may not be proportional to the size of the tear. Neer promoted the concept of three stages of rotator cuff disease. Stage I, according to Neer, occurred in those younger than 25 years and involved edema and
Rotator cuff tear postoperative pain or pain medication use apparently are not seen between arthroscopic- and open-surgery. Even for full-thickness rotator cuff tears, conservative care (i.e., nonsurgical treatment) outcomes are usually reasonably good. However, many people still have disability and pain despite nonsurgical therapies. For massive tears of the rotator cuff, surgery has shown durable outcomes on 10-year follow-up. However, the same study demonstrated ongoing and progressive fatty atrophy and repeat tears of the rotator cuff. MRI evidence of fatty atrophy in the rotator cuff prior to surgery is predicative of a poor surgical outcome. If the rotator cuff is completely torn, surgery