Do You Need Surgery for a Rotator Cuff Tear?

A rotator cuff tear can make simple tasks like reaching for a shelf or sleeping on your side feel impossible. If you are dealing with shoulder pain, you might worry that surgery is your only option. Fortunately, surgery is not the default path for most people.

At  Garden State Pain & Orthopedics, Dr. Deepan Patel, and our team help patients find the right path to recovery. 

 Is surgery always necessary for a rotator cuff tear? 

No, surgery isn't necessary for most rotator cuff tears. Both structured physical therapy and surgical repair can significantly improve how your shoulder feels and functions.

Many people are surprised to learn that an MRI tear does not always mean you need surgery. In fact, a systematic review in Frontiers in Physiology found that 23.6% of adults with no shoulder symptoms actually had rotator cuff tears. We treat you, not just your scan.

If your tear is small or developed slowly over time, we often start with conservative options. Our team designs a program to strengthen the surrounding shoulder muscles. This helps them compensate for the injured tendon and restores your mobility.

What are the risks of delaying surgery?

For traumatic rotator cuff tears, delaying surgical repair for three to six months is not associated with higher retear rates or worse functional outcomes compared to immediate surgery, though delays beyond a year do increase retear risk.

However, prolonged nonoperative management carries structural risks over time. In a 2026 prospective study in JSES International tracking nonoperatively managed tears over an average of 53 months, muscle atrophy progressed in 68% of shoulders, while fatty degeneration progressed in 12%. Because structural changes and muscle degeneration can advance during long-term nonoperative care, a prompt evaluation after a traumatic injury remains important to preserve shoulder function and determine the optimal timing for intervention.

 When a muscle is disconnected from the bone for years, it can weaken and turn into fat. Once this fatty change happens, the loss of strength may become permanent. If you experience a sudden, traumatic injury from a fall or accident, we recommend a prompt evaluation to protect your muscle function.

How we treat rotator cuff tears at Garden State Pain & Orthopedics 

We start with the least invasive treatments that can safely restore your shoulder function. Our specialists offer comprehensive pain management and physical therapy plans tailored to your specific goals. We focus on relieving your pain and rebuilding your strength so you can get back to your daily routine.

If conservative treatments do not provide relief, we also offer advanced surgical treatments. Our surgeons specialize in minimally invasive arthroscopic procedures. This approach uses tiny incisions, which can lead to less pain and a smoother recovery process. 

We walk you through every step of your recovery, whether you choose therapy or surgery. Our goal is to help you make an informed decision that fits your lifestyle and health history.

You do not have to live with limiting shoulder pain or guess about the best treatment path. Contact our team at Garden State Pain & Orthopedics today, or book online at one of our convenient New Jersey locations.