Somerville physical therapists discuss a study that shows surgery and non-surgical treatment lead to similar outcomes

Each month, our Somerville physical therapists do our best to keep you in the know on some of the most recent developments in the physical therapy research world. By explaining the findings of newly published studies, we strive to show our patients that you always have options when it comes to treating your injury; however, we believe that physical therapy is the best option available for most conditions.

This month we look into a study that compares the use of surgery to non-surgical treatment for tears of the rotator cuff. The rotator cuff is a group of tendons and muscles that surround the shoulder joint. It keeps the shoulder stable and allows it to rotate when performing any activities that require an overhead motion, like pitching and painting.

Due to the fact that it’s used so frequently, the rotator cuff is also very prone to injuries. Athletes like swimmers, baseball players and quarterbacks are at a particularly high risk for injuring their rotator cuff, but older adults are as well. It’s estimated that about 10% of adults over the age of 60 tears their rotator cuff every year. This is due to the amount of blood supply in the region, which decreases as we get older and makes it more difficult for the area to repair itself. Ultimately, this can lead to a tear.

Rotator cuff tears are usually treated either with surgery or a non-surgical (conservative) approach, which typically includes physical therapy to strengthen and stretch the shoulder. Although neither of these approaches has been found to be superior to the other, the rates for surgery have been increasing significantly in recent times. On top of this, between 20-90% of patients who have surgery do not heal or experience another tear within three years after the procedure.

Details of the study from our Somerville physical therapists

Since it’s not clear which is superior, a powerful study called a meta-analysis was conducted to determine whether surgery or conservative treatment was more effective for rotator cuff tears. To conduct the study, researchers searched through three medical databases for high-quality studies that compared the two treatment approaches. The search led to a total of three studies called randomized-controlled trials being accepted for the analysis. Researchers analyzed the findings of each of these studies and compared them to one another to develop an understanding of which was better overall.

Results showed that after one year, there were no significant differences between patients who had surgery compared to those who had conservative treatment. This was found to be the case based on similar scores for all patients in two measurements that were used for pain and shoulder function. These findings suggest that surgery leads to very similar outcomes and is no more effective than conservative treatment for rotator cuff tears. More high-quality studies are now needed to confirm these findings, but the analysis still shows that surgery and conservative treatment are comparable for these injuries.

This study presents yet another example of why physical therapy should be used first before considering a surgical procedure. Surgery is more expensive and associated with more side effects than physical therapy, and according to this study, it offers no advantages when it comes to treating rotator cuff tears. So if you’re dealing with a rotator cuff injury or any other pain, always visit our Somerville physical therapists first before considering any extreme treatments like surgery. Contact Arrow Physical Therapy & Rehabilitation at 908-393-9877 or click here to schedule an appointment at any of our four clinics in Union, Woodbridge, Edison or Somerville NJ.

To read the abstract (summary) of the study on rotator cuff tears, click here.