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A rotator cuff tear can be a cause of shoulder pain, but not every rotator cuff tear causes pain. In fact, rotator cuff tears are quite common in people with no symptoms at all. And especially as people get older, rotator cuff tears become more common.

Rotator Cuff Pain

The rotator cuff is the group of muscles and tendons that surround the ball-and-socket shoulder joint.  These muscles are important to help move and stabilize the shoulder joint.

When people tear their rotator cuff, common symptoms include pain and weakness of the shoulder.  Sometimes tears are caused by acute injuries, while other times a tear can occur without any known cause.

When a tear is determined to be a source of pain, patients will wonder about what is next.  The question comes up: what treatment is going to most effectively relieve pain and weakness of the shoulder?  Does the tear have to heal in order for the pain to resolve?

How Common Are Tears?

Not every rotator cuff tear causes significant pain or disability.  In fact, autopsy studies have shown rotator cuff tears in up to 70% of people over the age of 80 and 30% of people under the age of 70.  These are individuals who were not complaining of shoulder pain or disability.  MRI studies have confirmed these findings that many people have rotator cuff tears without having any symptoms of shoulder pain.

Because of this, most surgeons agree that not every rotator cuff tear requires surgical treatment for symptoms to resolve.  There are some situations where surgery may be recommended more urgently for rotator cuff tears:

  • Young patients: Rotator cuff tears become increasingly common as we age.  Once in your 60s and 70s, a rotator cuff tear is typically not considered abnormal.  However, tears in someone in their 20s or 30s are very abnormal.  Surgeons are much more likely to recommend surgery in younger patients.
  • Acute injuries: Acute tears are injuries that occur after major injuries such as falls.  MRIs can help determine if an injury to the rotator cuff is acute or chronic.  Acute tears can be more easily repair than chronic tears, and they are more likely to heal.

Bottom Line: Tears Are Common

Clearly, not everyone with a rotator cuff tear complains of painful symptoms. However, in many individuals, a rotator cuff tear can cause significant disability, and prompt diagnosis and treatment can profoundly improve symptoms.

Patients should understand that a rotator cuff team may not be an uncommon or unexpected finding.  And relief of pain may not require a surgical treatment.  While surgery can be an effective treatment for some types of rotator cuff tears, it may not be a necessary treatment for all rotator cuff tears.

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