A rotator cuff tear is one of the most common causes of shoulder pain — but a tear on a scan does not automatically mean you need surgery. The right decision depends on your symptoms, your activity level and how the shoulder responds to non-surgical treatment.
Not every tear needs an operation
For many patients, a structured programme of physiotherapy, activity modification and occasionally a guided injection is enough to settle symptoms and restore function. This is often the first step, particularly for smaller, degenerative tears.
When surgery is the better option
Surgical repair tends to give the best long-term result where there is a sudden traumatic tear, significant weakness, or where non-surgical treatment has not relieved pain after a reasonable trial. The aim is to reattach the tendon before the muscle weakens further.
- Sudden loss of strength after an injury
- Night pain that disturbs sleep
- Symptoms not improving after 3–6 months of physio
“The goal is never surgery for its own sake — it’s the right treatment, explained clearly, so you can make an informed choice.”
What recovery looks like
After an arthroscopic repair, a sling is worn for the first few weeks followed by a phased physiotherapy programme. Most patients return to desk work within 2–3 weeks and to full activity over four to six months.
IN THIS ARTICLE
Mr Aveek Mitra
Consultant Surgeon
Specialist in shoulder, elbow and upper-limb conditions in Nottingham.
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