Torn Rotator cuff & arthritis

i disagree with your belief to first do everything to avoid surgery. That is what i did and it resulted in a much worse injury that a top conplex shoulder surgeon in NY at HSS was the only surgeon i saw who felt he had the expertise to suceed. There were complications and it took years to heal. My surgeon told me the idea to try everything else first including lots of physical therapy contributed to the complexity of my surgery and my long complicated recovery

It seems that the words "..it all depends on the individual's specific circumstances AND the doctor(s) involved" can well apply here.
I'll share what happened when my orthopedist at a medical group I belonged to at the time, sent me to for a consult with a colleague within the same medical group, to check out the nauseating, excruciating pain in my left shoulder (resulting from a harsh fall onto concrete):

Dr. K was to evaluate the shoulder, upper arm, scapula and neck pain that had gotten worse after just 2 PT sessions. I was in agony.
THAT hubristic orthopedic surgeon was supposed to determine if modified PT should be continued to avert surgery. He came out with this, in a sternly dismissive voice:
"You don't have any tear, neither the radiologist nor Dr. G are correct. You SIMPLY have BURSITIS, and arthritis, but a shot in the joint will take care of that." I had had NO arthritis diagnosed for that shoulder EVER, nor had I experienced ANY pain prior to accident. I had led a pretty active lifestyle for a then-71 yr old. So I again told him how the fall onto concrete floor had caused me to have the forward motion get stopped by my extended hands and arms, and how THAT jammed my shoulders and forced them backwards. He snorted (yes, snorted!) again, and snapped "Do you want a shot to help with the arthritis and bursitis or not?" I hesitated because the intense pain that I'd had over a few weeks had improved with heat, Alleve, and "babying" the left arm. The pain level was a 7 (out of 10) that day in his exam room but over the prior days had me collapsed with unbearable pain. I acquiesced to having the injection, fearful of having the nauseating pain return. He injected the shoulder joint, and topped off the intimidating visit with "You'll be having bilateral shoulder surgery for sure." And with that, he left without a further word.

Fast forward about 3 weeks and I'm back at the sports medicine orthopedist who had sent me to him, my entire upper back, left scapula area, shoulder joint, upper arm, clavicle and across the neck ALL ablaze with hot, throbbing pain level 10/10. Her jaw dropped when I told her how he had refuted both her and the radiologist's report of the shoulder MRI. She apologized for having sent me to him, and supported no PT, just to continue allowing the torn cuff and tendons, etc., to heal. Well, the pain level was not acceptable so I left that doctor and sought help from another medical group affiliated with Columbia Presbyterian (but with an office near our town, not in NYC). THAT doctor was appalled by what she saw in the MRI and what the hubristic doctor had said and done. I was fighting back tears from the pain and my despair at not having been HEARD before. She asked (did not dictate to me, like the pompous male doc had done) if she could relieve the pain with injections to the areas. I agreed. Dr. B then ordered another set of MRIs of the shoulder and went over the findings with me at the subsequent visit. Pompous, hubristic doc had NOT taken into account how the complex injuries ALL contributed to my miserable existence: tendon tears, RCT, and ligament involvement. She discussed HER game plan, to which I agreed: Absolutely NO PT, NO surgery. Several followup visits, including one on an "emergency" basis due to the hot, searing nerve pain that one Thursday morning shot from shoulder, down the arm, and into my hand (with thumb pulsating in electrical pain). Again another shot, follow up visits. I continued watchful movements with that left arm. NO lifting, reaching, etc. Within 4 months from the first time in her office, I was finally pain free, no more grimaced face, and now 2 and 1/2 yrs later I am still PAIN FREE from those shoulder issues! There are activities that I've had to give up, such as lifting hand weights over my head, etc., but I can use light hand weights for curls, NO lifting up, off to the sides, etc. And I learned how to position my body when reaching for something in a cabinet or picking up. I have a small basket with handles into which I place items from the pantry or fridge as I set about prepping meals etc. I re-organized my pantry, kitchen drawers and shelves so that I am not over-reaching, etc. And I've had NO pain! AND NO surgeries! Dr. B had not been in favor of surgery for my shoulder, unlike the "other" God-complexed orthopedist.
BTW: My brother had bilateral shoulder surgery and he advised me "Don't do it, sis."

Dr. B also addressed the meniscus tear and tendon/ligament damages in the left knee that had resulted from the fall that had created the RCT of left shoulder and damage also to ulnar nerve in left forearm (same fall had created nerve damage and joint problems in the elbow, arm, hand/fingers). (Also ordered new MRI which guided her in creating a treatment plan for the knee.). Under her expert care, I've avoided surgery for the compounded issues resulting from the hard fall. Unfortunately, I still have problems with the knee due to the involvement with the nerve damage surrounding the knee, behind it, and up into thigh. BUT I've regained use of that knee and the constant pain is now a bearable low level. Following specific injections, she prescribed 2 months of PT, to strengthen the muscles. I can now manage stairs (very carefully) and have check-ups with Dr. B. NO SURGERIES for either body part! Unfortunately for me, she does not attend to foot injuries, and the Complex Regional Pain Syndrome that resulted from improper diagnosis treatment from first foot orthopedist has maintained a constant burning nerve pain in ankle/foot, up the lower leg and into the knee/sides. Yes, I've had an incredibly painful, long journey since that fall on June 7, 2021...

I share my experiences to illustrate how differently TWO specialists (both who do surgeries) approached my painful body parts. ONE (the male doctor) focused on surgeries (besides failing to LISTEN to me, and to dismiss other professional input). The other (Dr. B) focused on ME, the patient and what could work best without resorting to surgery automatically.

Bottom line: QUESTION, QUESTION, QUESTION. And ADVOCATE for yourself. Make sure that the medical plan offered to you is what YOU feel most comfortable with. ADJUST your activities, your home in order to best accommodate what your body needs. And ACCEPT that your lifestyle and everyday living will bring you the most satisfaction if you carefully revamp what needs to be done in order to enjoy your life. 😊
Pain may still be a companion (as with me, for various conditions) but you can MAKE joy for yourself. 🌺

Thank you for your detailed description of your injury and recovery. We have all met the doctor from @#$% at some point, and at least you had the ability to find a better doc.
I am awaiting shoulder surgery, which I elected after exploring the options with the surgeon, PA and my expert PT because I decided that I cannot live with the limitations you described as it is my dominant hand and I NEED a greater range of motion.
It is so important for people to make informed decisions, as you and I did, based on their circumstances. I hope at some point medical practice will find solutions for the terrible issues nerve damage can cause.
Keep being your own best advocate!

It seems that the words "..it all depends on the individual's specific circumstances AND the doctor(s) involved" can well apply here.
I'll share what happened when my orthopedist at a medical group I belonged to at the time, sent me to for a consult with a colleague within the same medical group, to check out the nauseating, excruciating pain in my left shoulder (resulting from a harsh fall onto concrete):

Dr. K was to evaluate the shoulder, upper arm, scapula and neck pain that had gotten worse after just 2 PT sessions. I was in agony.
THAT hubristic orthopedic surgeon was supposed to determine if modified PT should be continued to avert surgery. He came out with this, in a sternly dismissive voice:
"You don't have any tear, neither the radiologist nor Dr. G are correct. You SIMPLY have BURSITIS, and arthritis, but a shot in the joint will take care of that." I had had NO arthritis diagnosed for that shoulder EVER, nor had I experienced ANY pain prior to accident. I had led a pretty active lifestyle for a then-71 yr old. So I again told him how the fall onto concrete floor had caused me to have the forward motion get stopped by my extended hands and arms, and how THAT jammed my shoulders and forced them backwards. He snorted (yes, snorted!) again, and snapped "Do you want a shot to help with the arthritis and bursitis or not?" I hesitated because the intense pain that I'd had over a few weeks had improved with heat, Alleve, and "babying" the left arm. The pain level was a 7 (out of 10) that day in his exam room but over the prior days had me collapsed with unbearable pain. I acquiesced to having the injection, fearful of having the nauseating pain return. He injected the shoulder joint, and topped off the intimidating visit with "You'll be having bilateral shoulder surgery for sure." And with that, he left without a further word.

Fast forward about 3 weeks and I'm back at the sports medicine orthopedist who had sent me to him, my entire upper back, left scapula area, shoulder joint, upper arm, clavicle and across the neck ALL ablaze with hot, throbbing pain level 10/10. Her jaw dropped when I told her how he had refuted both her and the radiologist's report of the shoulder MRI. She apologized for having sent me to him, and supported no PT, just to continue allowing the torn cuff and tendons, etc., to heal. Well, the pain level was not acceptable so I left that doctor and sought help from another medical group affiliated with Columbia Presbyterian (but with an office near our town, not in NYC). THAT doctor was appalled by what she saw in the MRI and what the hubristic doctor had said and done. I was fighting back tears from the pain and my despair at not having been HEARD before. She asked (did not dictate to me, like the pompous male doc had done) if she could relieve the pain with injections to the areas. I agreed. Dr. B then ordered another set of MRIs of the shoulder and went over the findings with me at the subsequent visit. Pompous, hubristic doc had NOT taken into account how the complex injuries ALL contributed to my miserable existence: tendon tears, RCT, and ligament involvement. She discussed HER game plan, to which I agreed: Absolutely NO PT, NO surgery. Several followup visits, including one on an "emergency" basis due to the hot, searing nerve pain that one Thursday morning shot from shoulder, down the arm, and into my hand (with thumb pulsating in electrical pain). Again another shot, follow up visits. I continued watchful movements with that left arm. NO lifting, reaching, etc. Within 4 months from the first time in her office, I was finally pain free, no more grimaced face, and now 2 and 1/2 yrs later I am still PAIN FREE from those shoulder issues! There are activities that I've had to give up, such as lifting hand weights over my head, etc., but I can use light hand weights for curls, NO lifting up, off to the sides, etc. And I learned how to position my body when reaching for something in a cabinet or picking up. I have a small basket with handles into which I place items from the pantry or fridge as I set about prepping meals etc. I re-organized my pantry, kitchen drawers and shelves so that I am not over-reaching, etc. And I've had NO pain! AND NO surgeries! Dr. B had not been in favor of surgery for my shoulder, unlike the "other" God-complexed orthopedist.
BTW: My brother had bilateral shoulder surgery and he advised me "Don't do it, sis."

Dr. B also addressed the meniscus tear and tendon/ligament damages in the left knee that had resulted from the fall that had created the RCT of left shoulder and damage also to ulnar nerve in left forearm (same fall had created nerve damage and joint problems in the elbow, arm, hand/fingers). (Also ordered new MRI which guided her in creating a treatment plan for the knee.). Under her expert care, I've avoided surgery for the compounded issues resulting from the hard fall. Unfortunately, I still have problems with the knee due to the involvement with the nerve damage surrounding the knee, behind it, and up into thigh. BUT I've regained use of that knee and the constant pain is now a bearable low level. Following specific injections, she prescribed 2 months of PT, to strengthen the muscles. I can now manage stairs (very carefully) and have check-ups with Dr. B. NO SURGERIES for either body part! Unfortunately for me, she does not attend to foot injuries, and the Complex Regional Pain Syndrome that resulted from improper diagnosis treatment from first foot orthopedist has maintained a constant burning nerve pain in ankle/foot, up the lower leg and into the knee/sides. Yes, I've had an incredibly painful, long journey since that fall on June 7, 2021...

I share my experiences to illustrate how differently TWO specialists (both who do surgeries) approached my painful body parts. ONE (the male doctor) focused on surgeries (besides failing to LISTEN to me, and to dismiss other professional input). The other (Dr. B) focused on ME, the patient and what could work best without resorting to surgery automatically.

Bottom line: QUESTION, QUESTION, QUESTION. And ADVOCATE for yourself. Make sure that the medical plan offered to you is what YOU feel most comfortable with. ADJUST your activities, your home in order to best accommodate what your body needs. And ACCEPT that your lifestyle and everyday living will bring you the most satisfaction if you carefully revamp what needs to be done in order to enjoy your life. 😊
Pain may still be a companion (as with me, for various conditions) but you can MAKE joy for yourself. 🌺

Hello, Thank you for sharing your journey and advice. I thought I was reading my life. I had a similar fall June 8 2024 . I have been given prednisone and an orth gave me meloxocam I believe.
I am fed up with steroids but my RA Dr insists since I have several affected joints both from the fall and RA. My shoulder hurts so badly I can’t dry my hair and dressing is a challenge. Putting away dishes is painful as well and turning my neck to the right. I don’t want surgery either😔

Hello, Thank you for sharing your journey and advice. I thought I was reading my life. I had a similar fall June 8 2024 . I have been given prednisone and an orth gave me meloxocam I believe.
I am fed up with steroids but my RA Dr insists since I have several affected joints both from the fall and RA. My shoulder hurts so badly I can’t dry my hair and dressing is a challenge. Putting away dishes is painful as well and turning my neck to the right. I don’t want surgery either😔

Hello, Thank you for sharing your journey and advice. I thought I was reading my life. I had a similar fall June 8 2024 . I have been given prednisone and an orth gave me meloxocam I believe.
I am fed up with steroids but my RA Dr insists since I have several affected joints both from the fall and RA. My shoulder hurts so badly I can’t dry my hair and dressing is a challenge. Putting away dishes is painful as well and turning my neck to the right. I don’t want surgery either😔