Degenerative Rotator-Cuff Disorders

This article reviews the evaluation and management of degenerative rotator cuff disorders, which are common causes of shoulder pain in adults aged 40 and older. The authors discuss the clinical presentation, risk factors, and natural history of these disorders, emphasizing that tear size and thickness often correlate poorly with symptom severity. Nonoperative treatments, including physical therapy and pharmacologic options (e.g., NSAIDs, glucocorticoid injections), are recommended as initial approaches. Surgical intervention may be considered for patients who do not respond to conservative measures, particularly those with smaller tears and lower fear-avoidance behavior. The article highlights areas of uncertainty, such as the etiology of degenerative tears and the role of early surgery, and aligns with guidelines from the American Academy of Orthopaedic Surgeons.

This article reviews the evaluation and management of degenerative rotator cuff disorders, which are common causes of shoulder pain in adults aged 40 and older. The authors discuss the clinical presentation, risk factors, and natural history of these disorders, emphasizing that tear size and thickness often correlate poorly with symptom severity. Nonoperative treatments, including physical therapy and pharmacologic options (e.g., NSAIDs, glucocorticoid injections), are recommended as initial approaches. Surgical intervention may be considered for patients who do not respond to conservative measures, particularly those with smaller tears and lower fear-avoidance behavior. The article highlights areas of uncertainty, such as the etiology of degenerative tears and the role of early surgery, and aligns with guidelines from the American Academy of Orthopaedic Surgeons.