'Rotator Cuff Tear', Often Confused with Frozen Shoulder, Requires Accurate Diagnosis and Treatment

[Asia Economy Reporter Lee Gwan-ju] During cold winter weather, muscles and ligaments easily stiffen, increasing pain from joint diseases such as shoulder pain. A representative disease is 'Oshipgyeon' (Frozen Shoulder), which is often confused with 'Rotator Cuff Tear.'

The rotator cuff, referring to the muscles and tendons surrounding the shoulder joint, consists of four muscles: supraspinatus, infraspinatus, subscapularis, and teres minor. It plays a role in moving the shoulder joint and maintaining its stability. Rotator cuff tear is a condition where one or more of these muscles are torn, causing pain or dysfunction in the shoulder. The shoulder tendons have a small muscle cross-sectional area and relatively poor blood supply, and they experience friction with the bone called the 'gyeonbong' (acromion) directly above, making fatigue accumulation and degenerative changes easy to occur.

The most common cause of this disease is degenerative changes that naturally occur with aging, but other factors such as trauma, inflammatory diseases, anatomical abnormalities, and circulatory disorders also contribute to its onset. Rotator cuff tear occurs due to various causes and complex interactions. When the rotator cuff is torn, pain occurs temporarily and then improves repeatedly, gradually spreading to the neck and arm. Pain is especially severe when raising the arm upward or stretching it behind the body.

Because of this, many middle-aged people mistake rotator cuff tear for Oshipgyeon. However, rotator cuff tear and Oshipgyeon differ from the cause of the disease to the symptoms. Oshipgyeon is shoulder pain caused by thickened joint capsules adhering to tendons and ligaments without a specific cause, resulting in pain felt throughout the shoulder and upper arm when raising or rotating the arm. In contrast, rotator cuff tear mainly appears due to degenerative changes, with tendons weakening or tearing from excessive exercise or external impact.

Orthopedic specialist Noh Yeon-tae at H Plus Yangji Hospital explained, “The most common symptom is shoulder pain, often reported as pain in the upper deltoid area of the arm, and many patients complain of night pain that wakes them up while sleeping. Patients with cervical disc disease may also experience trapezius pain and finger numbness.”

Treatment is divided into partial tear and complete tear depending on the degree of the tear. Partial tear patients undergo conservative treatment, including medication, physical therapy, stretching, and muscle strengthening exercises, and if pain is not controlled, injection therapy is combined. If pain persists after six months of conservative treatment or imaging tests show progression of the tear, surgical treatment may be attempted.

In the case of complete tears, surgical treatment is primarily considered, but surgery is not performed in all cases. The decision is carefully made based on the patient's age, degree of functional limitation, required function, pain severity, and duration. Surgical methods include arthroscopic repair surgery, open repair surgery, and artificial joint replacement surgery. Most surgeries are performed arthroscopically by making a small hole in the skin to insert a camera, observing the extent of the rotator cuff tear, and suturing the damaged rotator cuff. If the tear is large and arthroscopic repair is difficult, additional incisions are made for repair surgery. When the complete tear is extensive and degenerative changes have progressed over a long period, making repair difficult, reverse total shoulder arthroplasty can restore shoulder joint function in such advanced cases.

After rotator cuff tear surgery, the shoulder cannot be used immediately and rehabilitation therapy is essential. Immobilization treatment is performed for 4 to 6 weeks after surgery, followed by about 1 to 2 months of rehabilitation therapy to restore the range of motion of the shoulder joint. The larger the tear, the more it can affect surgical treatment outcomes. Specialist Noh Yeon-tae advised, “Extensive rotator cuff tears, not in the early stage, may have poor prognosis even after surgery, so early detection of this disease is very important. If shoulder pain persists for more than 3 to 4 weeks, do not neglect it and visit a hospital to receive an accurate diagnosis and treatment from an orthopedic specialist.”

This content was produced with the assistance of AI translation services.