Dr. Lee's Expert Q&A

Injection therapy for rotator cuff tears aims to reduce inflammation and relieve pain, or to promote recovery of damaged tissue. However, not all patients experience the same benefit — limited effectiveness is entirely possible in some cases.

In particular, when the extent of the tear is large or significant tendon degeneration has progressed, structural recovery through injection alone may be difficult to expect. In such cases, pain may temporarily decrease but return over time.

When injection therapy is insufficiently effective, reassessing the current condition is important. After confirming tear extent and status via MRI or ultrasound, the treatment direction is adjusted. This may involve augmenting regenerative injection therapy, adding shockwave and rehabilitation therapy, or — in appropriate cases — considering a procedure or surgical treatment to directly restore the damaged tendon.

Injections can be an effective treatment for early or mild injuries, but they are not the solution at every stage. If symptoms are recurring or not improving, rather than simply repeating injections, a precise reassessment followed by a next-stage treatment plan is the important step.

Calcific tendinitis is not a condition that absolutely requires surgery. In fact, in many cases, symptoms can be sufficiently improved without surgery.

Conservative treatment including medication, shockwave therapy, and injection therapy can first be used to reduce inflammation and manage pain. However, when pain is severe, the calcium is large, or conservative treatment shows no improvement, more aggressive treatment may be necessary.

In such cases, a non-surgical alternative is calcific aspiration. This procedure confirms the calcium location under ultrasound, physically crushes the hardened calcium into fine pieces, and removes it by aspiration. Since it is performed without incision, it can be an excellent alternative for patients with a large burden from surgery.

In particular, since the calcium that is the direct cause of pain is removed, rapid pain relief can be expected. Recovery after the procedure is relatively quick, which is advantageous for returning to daily life. If surgery for calcific tendinitis is burdensome, it is recommended to first accurately assess the current condition and preferentially consider conservative treatment along with non-surgical options such as calcific aspiration.

Calcific tendinitis is a condition where calcium deposits in the tendon cause acute inflammation and extreme pain. Especially when night pain is severe or pain persists even at rest, rapid improvement with simple medication or physical therapy alone is often difficult. In such cases, calcific aspiration is a treatment to consider.

First, the source of pain can be directly removed. Rather than simply reducing inflammation, the calcium that is the direct cause of pain is removed — allowing rapid pain relief.

Second, the recovery speed is relatively fast. As a procedure performed without incision, return to daily activities after the procedure is generally possible relatively quickly.

Third, it helps reduce the possibility of recurrence. A state where calcium has been removed is more advantageous for reducing the possibility of pain recurrence than a state where calcium remains. However, since the timing of treatment can differ depending on the size and location of the calcium and the inflammatory state, it is important to make a decision after precise examination.

Shoulder plication suture is a treatment method applicable when the rotator cuff is not completely torn but partially damaged. It works by pulling the damaged tendon back and securing it in place — the characteristic being to induce functional recovery while preserving existing tissue to the maximum extent.

Pain reduction: As the tension of the stretched tendon is restored, pain that occurred during movement decreases in many cases. Shoulder function recovery: Discomfort when lifting or rotating the arm improves, making daily activities considerably easier.

The recovery period is relatively fast. Generally, normal daily life is possible in about 2–4 weeks, and exercise or heavy use is progressed gradually with rehabilitation.

However, it is not applicable to all patients. When the tendon tear is large or completely severed (full-thickness tear), or when muscle atrophy has progressed, plication suture alone may have limitations. When performed in appropriate candidates, it is sufficiently beneficial for pain relief and functional recovery — making precise examination for judgment important.

Being diagnosed with a rotator cuff tear does not mean surgery is required in every case. In practice, there are quite a few patients who can manage symptoms and recover function without rotator cuff tear surgery.

The first important thing is the degree of the tear — whether it is a partial or full-thickness tear, and the treatment direction differs completely depending on the size and location of the tear and whether muscle atrophy is present. For partial tears or tears that are not large, non-surgical treatment can be considered first.

Representative non-surgical treatments include injection therapy to control inflammation and pain, regenerative injection therapy to promote recovery of damaged tendons, shockwave therapy, and exercise therapy and rehabilitation. Through such treatment, pain is sufficiently reduced and recovery to a level that does not interfere with daily life is achieved in many cases.

Ultimately, whether surgery is needed is not determined by a single diagnosis name, but must be judged by considering the current functional state and imaging examination results together. Avoiding unnecessary surgery while not missing the treatment window is most important.