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)
Synovial sheath Synovial sheath A synovial sheath is one of the two membranes of a tendon sheath which covers a tendon. The other membrane is the outer fibrous tendon sheath. The tendon invaginates the synovial sheath from one side so that the tendon is suspended from the membrane by the mesotendon, through which the blood vessels reach the tendon, in places where the range of movement is extensive. The mesotendon disappears or remains in the form of narrow tendinous bands as threads known as vincula tendina. The synovial sheath is found where the tendon passes under ligaments and through osseofibrous tunnels; their