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Shoulder / Rotator Cuff Problems Message Board
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Old 01-15-2013, 07:00 PM   #1
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Full-thickness tear of supraspinous tendon

My MRI shows that my right shoulder has: Full-thickness tear of supraspinous tendon with fluid in the subdeltoid and subacromial bursa with no muscle retraction. Increased signal in the distal supraspinatus tendon consistent with tendinosis. Fluid signal in the superior greater tuberosity at the attachment of the supraspinous tendon (which is a subcortical cyst). Hypertrophy of the acromioclavicular joint with moderate impigement.

I saw my ortho surgeon yesterday. I am female, age 71, with a history of trigeminal neuralgia, fibromyalgia, and reflex sympathetic distrophy, as well as hyprothyroid, diabetes, high blood pressure, and a few other tidbits just for fun.

Some years back I had two full thickness tears in my left shoulder. They operated, removed part of the acromion hook, and wired and pasted everything back together. The pain was incredible, at that time I was on Elavil and occasional Vicodin as needed for the fibro. Needless to say, they put me on some stronger meds for a while.

At this time, however, I am daily on much stronger pain meds, as well as meds for the other various complaints I have been blessed with. My biggest concern is that the surgeon does not wish to add more drugs to the ones I already take, which I do understand completely. If I had my way, I would be on nothing, nada, zero, zip.

I have talked to my pharmacist (he deals with pain management as a speciality) and asked about weaning myself off the pain drugs before having the surgery (if I decide to have surgery.) He said this is currently not the recommended protocol, it would take at least three months and put me through misery. At present, the recommendations of the experts is to continue the current meds and just add whatever pain meds are standard for this type of surgery (yes, I know, that would be a high dosage all together).

I will be seeing my pain control specialist in a few weeks to discuss this with him. I trust him, and have been on the same dosages for over 10 years with only one bump in one of the stronger drugs, and that was from 10mg three times daily to 20 mgs, same schedule.

The tear is full thickness, but the muscle is not retracted. The surgeon said it looked like it shredded, more like it pulled apart slowly rather than tore all at once. He is leaving the decision on surgery up to me, the three possibilities are:
1) nothing happens, just continue as things are, hopefully for the next 30+ years (hey, I'm an optimist)!
2) have the surgery, or
3) not have the surgery but face the possibility that the muscle will contract and the rotator cuff repair, as such, will not be possible. That would mean a shoulder replacement, a much bigger problem.

Although I am retired from my "standard lifelong work", I work with my husband in an art-related business. We attend many art shows, which means setting up an 18 ft. long display with heavy product... My husband is disabled, so I do a signifiant amount of lifting and carrying, setting up, etc.

The surgeon also said it would be six weeks in a sling, no PT except for pendulum movemnts. After that, PT would start. Based on last time, that would put me out of commission for about 18 months as far as the display and my work. I should mention that this income is needed to pay our every-day bills.

I am currently have a fair amount of discomfort, with poor sleep, but I am not in angony. I remember both times I tore the cuff in the other arm, and if that were the case I would be throwing myself on the operating table and handing the surgeon the scapel. I have good range of motion still, for the most part. I personally believe that muscle may have a full thickness tear, but is still functional for the moment... but how long will that last?

Now I have to decide what am I going to do. There are pros and cons on both sides. I hope to learn from your experiences, especially if anyone else is in in a similiar boat. Thank you for your patience with this long introduction, but I thought knowing the full story (for the most part) up front might be better than everyone having to ask questions.

 
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Old 01-18-2013, 06:00 AM   #2
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Re: Full-thickness tear of supraspinous tendon

Cuff repair is a lot different today than it was 20 years ago. Although arthroscopic is just as painful as open, recover time is much less than 18 months. On the other hand, many people at your age do have cuff tears from degeneration. Just goes with the territory! Most people live with them, and do not go for surgery. So, it comes down to whether the pain is enough that you absolutely cannot live with it one more day, or is it manageable with meds and pt.

I went from an injury - full thickness complete massive tear and bone contusion - to cuff repair to hemiarthroplasty to total shoulder replacement in 3 years, soon to be followed by revision reverse replacement, so I know shoulder pain.

 
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