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 or arthritis. Superior labral anterior-posterior lesions produce pain similar to that of rotator cuff tears. Those most prone to failed rotator cuff syndrome are patients 65 years of age or older; and those with large, sustained tears. Smokers, diabetes sufferers, patients with muscle atrophy and/or fatty infiltration, and those who do not follow postoperative-care recommendations also are at greater risk. Doctors examine patients and conduct imaging tests to identify the causes of continued discomfort. Depending upon the diagnosis, several treatment alternatives are available. They include revision repair, nonanatomic repair, tendon transfer and arthroplasty. When possible, surgeons make tension-free repairs in