Is Surgery the Best Option for Rotator Cuff Problems or Is Chiropractic Treatment Effective?
Rotator cuff tears (RCTs) are a common musculoskeletal issue, particularly among the middle-aged and the elderly.
The rotator cuff is a group of four muscles and their tendons that stabilize the shoulder joint and facilitate various arm movements. Tears can happen due to acute trauma, like a fall or direct impact to the shoulder, or as a result of chronic degenerative changes associated with aging and repetitive overhead activities
The prevalence of Rotator cuff tears rises with age, impacting approximately 30% of individuals in their 60s and more than 60% of those over 80 years old
The choice between surgical and non-surgical management is influenced by several factors, such as the tear’s size and location, the patient’s age, activity level, and comorbidities
Platelet-Rich Plasma Therapy
Platelet-rich plasma (PRP) therapy has emerged as a promising non-surgical intervention for RCTs. Short-term outcomes of PRP therapy often include substantial pain relief and enhanced shoulder function within the first six months post-treatment. PRP therapy can enhance the healing process by promoting tissue regeneration and reducing inflammation
Non-surgical options are often the first line of management, particularly for partial tears or patients who are not suitable candidates for surgery. These interventions aim to alleviate pain and improve function and the Quality of Life.
Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce inflammation and alleviate pain. For patients who cannot tolerate NSAIDs, acetaminophen serves as a viable alternative
Post Surgery Rehab
Research released in 2021 found that supervised PT and bracing in 15 degrees external rotation after arthroscopic repair are effective. Early isometric loading showed improved outcomes in one study, while TENS helped manage pain
Evaluating the cost-effectiveness of various treatment strategies
Research findings indicate that arthroscopic repair is generally cost-effective, particularly for younger patients, due to significant improvements in functional scores and quality-adjusted life years (QALYs).
Another study found that while non-surgical management is the least costly, it often results in lower functional outcomes and higher long-term healthcare costs due to ongoing treatment needs.
Among the surgical options, Superior capsular reconstruction and Reverse shoulder arthroplasty, despite their higher initial costs, provide better functional outcomes and higher QALYs
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Reference
Altamimi TA, Alkathami AA, Al-Awn RMM, Alkhaldi MHE, Alhudaithi MHM, Alqahtani AA, Alzahrani AAS, Aladwani SSM, Abdulrahman AF, Almutawah ANA. A Narrative Review of Rotator Cuff Tear Management: Surgery Versus Conservative Treatment. Cureus. 2024 Dec 2;16(12):e74988. doi: 10.7759/cureus.74988. PMID: 39744305; PMCID: PMC11692865.
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