Partial supraspinatus tendon tear causing lots of pain: weighing treatment options?
Background; I’ve been having pain in my right shoulder (dominant side) for over a year now. It started during a workout, where I felt a sharp pain during a shoulder press. I was already in PT for my neck pain and generally dealing with a lot, and the pain wasn’t too bad, so I just left it alone and figured it would feel better if I rested it. It was fine for a bit, but the last few months the pain has gotten a lot worse.
I saw a shoulder doc and did 3 months PT with minimal to no improvement, then went for MRI which showed a bursal sided partial tear in the supraspinatus tendon (from radiology report: “the erosion on the tendons bursal surface measures 8 x 8 mm in diameter, involving estimated 20% tendon thickness”). There’s also a small bone spur pressing down on the tendon.
The shoulder specialist says he’s confident the tear is what’s causing my pain (and I am too) but because I also have some issues with my neck, although that predates my shoulder pain which began during a specific incident (bulging discs and stenosis from C4–C6), the shoulder doc wants to confirm my neck is not causing my shoulder pain before potentially doing anything invasive like surgery.
So we are going to start with a steroid injection in the shoulder, which will hopefully help with the pain at least in the short term and also serve as a diagnostic tool to make sure it’s not my neck creating this pain.
But, if the steroid helps and then the pain returns, I need to decide whether to proceed with surgery or not to repair the tear.
He says there’s a chance that with a combination of the steroid injection bringing down the inflammation and continued PT, my shoulder could get better on its own or at least get to a place where I decide I can live with it. If that doesn’t happen, he says he can’t recommend continuing steroid injections because it’s not healthy for the tissue. So it seems my options at that point would be A) surgery or B) PRP injections and continuing PT.
I’m not there yet, because I haven’t even gotten the steroid injection yet, but I’m just trying to weigh my options in case a few weeks/months after the injection my pain comes back at the same level where it is now. So basically I’m just curious about anyone’s experience with these options for a similar tear as mine, a small bursal sided supraspinatus tendon tear.