Shoulder Pain Dilemma: Seeking Solutions for Rotator Cuff and Bone Spurs

Shoulder issues

Hello Dr.
Lee, I had a significant shoulder injury from working with a hammer a long time ago, and I've experienced pain for several years.
Recently, even sleeping on it causes pain.
I have undergone X-rays and an MRI, but the opinions from the two doctors differ.
Doctor 1 says I have bone spurs, while Doctor 2 states that I have a rotator cuff tear without bone spurs.
Both doctors recommend surgical treatment.
What should I do in this situation? Thank you.

Wen Sheng, 60~69 year old female. Ask Date: 2017/07/27

Dr. Li Yongheng reply Orthopedics

Hello, bone spurs can cause rotator cuff tears.
If both doctors recommend surgical treatment, you should carefully consider proceeding with it.
Currently, minimally invasive arthroscopic shoulder surgery is available, which allows for quick recovery and smaller incisions, so there is no need to worry too much.
Wishing you a speedy recovery.

Reply Date: 2017/07/27

More Info

Hello! It sounds like you're dealing with a complex situation regarding your shoulder pain, particularly concerning the rotator cuff and potential bone spurs. Given the conflicting opinions from the two doctors you've consulted, it's essential to approach this matter systematically to find the best course of action.

Understanding Your Condition
From your description, it seems you have a history of shoulder injury that has led to chronic pain. The two primary issues at play here are:
1. Rotator Cuff Injury: This could involve a tear in the rotator cuff tendons, which are crucial for shoulder stability and movement. A complete tear can lead to significant pain and functional limitations, especially when lifting or reaching overhead.

2. Bone Spurs: These are bony projections that develop along the edges of bones, often in response to joint damage or arthritis. They can cause pain by impinging on surrounding tissues, including tendons and nerves.

Diagnostic Confusion
The differing opinions from your doctors regarding the presence of bone spurs and the condition of your rotator cuff highlight the complexity of shoulder injuries. Imaging studies like X-rays and MRIs can sometimes yield ambiguous results, leading to different interpretations.
- X-rays are typically used to assess bone structure and can show bone spurs.

- MRI is more effective at visualizing soft tissues, including muscles, tendons, and ligaments, which is crucial for diagnosing rotator cuff tears.

Next Steps
1. Seek a Third Opinion: Given the conflicting diagnoses, it might be beneficial to consult a third orthopedic specialist, preferably one who specializes in shoulder injuries. They can review your imaging studies and provide a fresh perspective.

2. Consider a Comprehensive Evaluation: Ensure that the new doctor conducts a thorough physical examination and possibly additional imaging if necessary. Sometimes, a diagnostic injection can help determine the source of pain.

3. Conservative Management: Before jumping into surgery, consider conservative treatment options. These may include:
- Physical Therapy: A tailored rehabilitation program can strengthen the shoulder muscles, improve range of motion, and reduce pain.

- Corticosteroid Injections: These can provide temporary relief from inflammation and pain, especially if bone spurs are contributing to your symptoms.

- Activity Modification: Avoiding activities that exacerbate your pain can help manage symptoms.

4. Surgical Considerations: If conservative treatments fail and your quality of life is significantly affected, surgery may be warranted. Surgical options can include:
- Rotator Cuff Repair: If a tear is confirmed, repairing the tendon can restore function and alleviate pain.

- Subacromial Decompression: This procedure removes bone spurs and other tissue that may be impinging on the rotator cuff.

Conclusion
Navigating shoulder pain, especially with conflicting medical opinions, can be frustrating. It's crucial to gather as much information as possible and consider all treatment options. Consulting with a specialist who can provide clarity on your diagnosis and treatment plan is essential. Remember, the goal is to restore function and reduce pain, allowing you to return to your daily activities without discomfort. Don't hesitate to advocate for yourself and seek the care you need to achieve the best outcome.

Similar Q&A

Should You Consider Surgery for Shoulder Bone Spurs? Expert Advice

Hello Doctor, last year I experienced shoulder pain and later had an X-ray that revealed bone spurs. Now, whenever I lift heavy objects, my entire arm becomes sore, numb, and weak. An orthopedic surgeon previously suggested surgery to remove the bone spurs, but I am concerned abo...

Dr. Wang Zhaomin reply Rehabilitation
Shoulder pain and cervical intervertebral disc compression issues can be treated with medication, injections, rehabilitation, or surgery. Each individual's condition is different, so it cannot be generalized. This is a consultation platform and cannot provide a diagnosis; pl...

Understanding Shoulder Pain: Bone Spurs or Inflammation?

Dear Dr. Lee, Three months ago, I started experiencing pain from my left shoulder down to my arm. I initially thought it was due to a stiff neck. Two months ago, I visited a hospital where I was told I have bone spurs. However, medication and injections have not helped. Later, I...

Dr. Li Wenlin reply Orthopedics
Hello: In response to your inquiry, based on your description, the likelihood of a shoulder joint issue or a cervical spine problem is the highest. Please consult an orthopedic physician for an examination, as this will likely help resolve your issue promptly.

Managing Shoulder Tendonitis: Effective Pain Relief Strategies

Family members report pain at the shoulder and upper arm junction (the joint that moves when raising the arm), which makes it difficult to lift the arm even when turning in bed during sleep. They need to assist with the other hand to move it. There was some improvement after cons...

Dr. Chen Xingyuan reply Orthopedics
Dear User: Based on your description, the pain you are experiencing may be caused by tendonitis. The causes of tendonitis can include overuse, improper use, injury, and poor posture. Generally speaking, avoiding these situations, getting plenty of rest, applying heat, and perform...

Managing Persistent Shoulder and Arm Joint Pain: Expert Advice

I have been suffering from shoulder and arm joint pain for about 2 years. In 2000, I had a cervical X-ray at Mackay Memorial Hospital, which showed no bone spurs, and nerve tests were normal. The doctor advised me not to exert myself too much with household chores, and that it wo...

Dr. Shi Guozheng reply Orthopedics
Shoulder pain lasting for two years with normal radiographic findings of the joint is most likely due to conditions such as tendinitis or capsulitis. If there is limited range of motion, particularly in extension and elevation, adhesive capsulitis, commonly known as frozen should...