Rotator cuff tear 2010 found no solid evidence that rotator-cuff surgery benefited people more than nonoperative management. Those with pain but reasonably maintained function are suitable for nonoperative management. This includes oral medications that provide pain relief such as anti-inflammatory agents, topical pain relievers such as cold packs, and if warranted, subacromial corticosteroid/local anesthetic injection. An alternative to injection is iontophoresis, a battery-powered patch which "drives" the medication to the target tissue. A sling may be offered for short-term comfort, with the understanding that undesirable shoulder stiffness can develop with prolonged immobilization. Early physical therapy may afford pain relief with modalities (e.g. iontophoresis)
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