Rotator Cuff Tears: Is non-surgical management effective? Read on if curious

I recently read a great narrative review of the medical literature that was published a few weeks ago that is titled "Rotator cuff tears: is non-surgical management effective." For those not familiar, narrative reviews are great ways to get a TON of information about a single topic, and typically guide the reader through several other studies in order to determine a consensus. In this case, the authors looked at surgical management vs non-surgical management of rotator cuff tears. If you'd like to read the article yourself, here you go:

http://www.tandfonline.com/…/full/10…/10833196.2016.1271504…

I won't bog you down with the details, so here are the takeaways:

1) There were only 3 studies that looked at long-term outcomes in people who had surgery vs those who chose non-surgical intervention.

2) Outcomes had a small but NOT SIGNIFICANT effect in favor of surgery.

3) Average cost of care for surgical patients: $6,079. Average cost of care for non-surgical patients: $2,573. The biggest driver of cost was advanced imaging (MRI), which the study also called into question regarding the value of this service.

Whoa! So we have patients being told that they need to get an MRI and that they need to have surgery because surgery is better. All the while we have very little understanding of what the patient looks like after one year post-operation, and that rehab was JUST THE SAME as surgery, at a FRACTION of the cost.

Yes, there are those that need surgery. I've seen them and refer them. But please do yourself a favor and attempt rehab first. It could save you time, money, and maybe a little sanity.

Dr. Evan Kahn, DC, DACBSP