Surgery vs. Conservative Care in Shoulder Injury Treatment

Traditionally, rotator cuff tears and similar such injuries have been managed through a biomedical model, whereby a physical abnormality is found on a scan and is handled surgically to remove pain. However, today we are more aware that abnormalities are not constantly connected to shoulder pain and physiotherapy is an effective choice for many shoulder injuries. With this knowledge, physicians are now reevaluating the suitability and usefulness of advanced imagining and surgical techniques as the primary path of treatment for shoulder injuries.

Shoulder pain has acquired added awareness in the last twenty years due to its occurrence in the baby boomer generation. Research indicates that partial or full-thickness tears appear in more than 50% of 70-year-olds and 80% of individuals over 80 years old. Additionally, such shoulder injuries can be present without symptoms.

Imaging in the first months after a shoulder injury is now considered to be avoidable except if there is serious trauma to the shoulder. In cases where there are traumatic or acute tears, aggressive and operative treatments are more commonly entailed. Research displays that injuries, such as first time-traumatic anterior shoulder dislocation (most commonly found in young males) is better treated with a surgical approach to decrease the possibility of recurrence. For cases where the injury is non-traumatic, a physiotherapy treatment displays assuring results.

A case study published in the Bone and Joint Journal of Finland analyzed the treatment of non-traumatic rotator cuff tears. The study divided 173 patients into three groups: the first group received physiotherapy online, the second group received acromioplasty (surgical procedure of the acromion) and physiotherapy, and the third group received rotator cuff treatment, acromioplasty, and physiotherapy. Patients were analyzed at three months, six months, and one year and researchers found considerable similarity in degrees of improvement amongst all groups. The overall conclusion of this study displayed that physiotherapy alone yielded equal outcome to results produced by arthroscopic surgery and open surgical repair.

In summary…

  • Physiotherapy for a non-traumatic shoulder injury is a very effective form of treatment
  • It is a significant way to avoid invasive procedures that require a great deal of recovery time.
  • Research has proven that it is equally as effective as surgery if an individual fully commits himself/herself to the physiotherapy process.

 

Sources:

 https://www.medrisknet.com/case-conservative-care-shoulder-injury-treatment/

 http://www.apta.org/PTinMotion/NewsNow/2014/3/12/RotatorCuffTears/?blogid=10737418615