Rotator Cuff Tear

Q I am a 59-year-old construction site manager. I was advised to have surgery at the hospital. Is it really true that there is no other option besides surgery? Is it possible to avoid surgery through traditional Korean medicine treatment?

A. It depends on the size and type of the rupture. Partial ruptures and small to medium full-thickness ruptures often improve sufficiently with conservative treatment, so the standard practice is to try non-surgical treatment for 3 to 6 months first. However, in cases of acute traumatic full-thickness ruptures, extensive ruptures, or significant muscle weakness, it is crucial not to miss the timing for surgery, so the decision must be made based on accurate imaging evaluation.

Q I am a 50-year-old housewife. I underwent rotator cuff repair surgery last year, but I still feel stiffness and my strength hasn't fully returned. Is Korean traditional medicine treatment meaningful even after surgery?

A. Residual pain and muscle weakness after surgery are common issues, and this is precisely the period when Korean traditional medicine can play a role. The approach involves using acupuncture and pharmacopuncture to release hardened fascia and adhesions around the surgical site, and herbal medicine to boost recovery power and improve the efficiency of rehabilitation. We also address the restoration of shoulder balance to prevent re-rupture.

Q I am a 46-year-old IT developer. I was diagnosed with a partial rotator cuff tear, and my neck is always stiff while my arm occasionally feels numb. Do I have a herniated disc in my neck as well, or are the two related?

A. A significant number of patients with shoulder pain also have cervical spine issues, and since the symptoms of the two overlap, differentiation is necessary. Numbness in the arm and pain that varies with neck movement are likely cervical, while pain when lifting the arm is likely a rotator cuff problem. If the two conditions coexist, treating only one side will not fully resolve the pain, so they must be evaluated and treated together.

Q I am a 51-year-old nurse. I wake up two or three times every night due to shoulder pain. Is there a good sleeping position for a patient with a rotator cuff tear?

A. Lying on the opposite side with the painful shoulder facing upward, and placing a pillow or cushion under the painful arm to keep it slightly elevated in front of the body, reduces tendon compression. When lying on your back, place a thin cushion under the painful elbow. Lying on the painful side is the position you should avoid the most.

Q I am a 43-year-old member of a badminton club. I stopped all exercise after being diagnosed with a partial tear, but my shoulder feels like it is actually getting stiffer. Which exercises are acceptable, and which are not?

A. Complete rest actually causes the shoulder to stiffen. Pendulum exercises within a pain-free range, scapular adduction exercises, and light isometric exercises are recommended. On the other hand, smashing motions (swinging the arms overhead) and lifting heavy objects overhead should be avoided until recovery is complete. Please decide whether to return to exercise after a stage assessment.

Q I am a 69-year-old woman. I have osteoporosis and diabetes. Are treatments like *Dochim* (straight-tip acupuncture) or *Hwachim* (fire acupuncture) safe for my age? I am worried that my tendons might be further damaged.

A. *Dochim* and *Hwachim* are treatments that can be safely applied even in the elderly if performed while confirming the location and depth of the lesion using ultrasound. Since osteoporosis is a bone issue, it does not directly conflict with soft tissue procedures, and for diabetes, the intensity of the procedure is adjusted after checking infection control and blood sugar levels. It is most important to accurately inform us of your underlying conditions during the initial consultation.

Q I am a 63-year-old male. Is it okay to take herbal medicine along with the anti-inflammatory painkillers prescribed by an orthopedic doctor? I am also taking blood pressure medication.

A. In most cases, co-administration is possible if you space the dosage times by about two hours. However, if you accurately inform us of the specific types of anti-inflammatory painkillers and blood pressure medication you are currently taking during your consultation, we will adjust the herbal medicine prescription considering potential interactions. Please do not combine them arbitrarily based on your own judgment; you must consult with a medical professional before making a decision.

Q I am a 47-year-old childcare teacher. I have been diagnosed with a partial rotator cuff tear. If I undergo treatment, how long does it usually take to recover enough to be able to lift children?

A. Conservative treatment for a partial tear is generally considered to take 3 to 6 months per cycle. Night pain and daily pain begin to subside as early as 4 to 8 weeks, and the ability to lift heavy objects recovers gradually thereafter. However, since there is significant individual variation depending on the size of the tear, age, and adherence to treatment, adjustments are made through intermediate evaluations.

Q I am a 66-year-old retiree. The pain is bearable, so I have just been leaving it alone, but what happens if a rotator cuff tear is not treated?

A. It is reported that if a partial tear is left untreated, about half of them will enlarge within a few years. As the tear grows, the tendon retracts inward, and fatty degeneration occurs in the muscle, which can eventually lead to a condition where suturing becomes difficult even with surgery. Even if the pain is mild, regular follow-up and active management are necessary.

Q I am a 52-year-old housewife. I have never injured my shoulder, but I have been told that my rotator cuff is torn. I have never fallen or bumped into anything, so how can it rupture?

A. More than half of rotator cuff tears are degenerative tears that occur without trauma. After the age of 40, if repetitive use of the arm accumulates while blood flow to the tendons decreases and elasticity declines, the tendons can gradually wear down and tear even without a specific accident. This is particularly common in the supraspinatus tendon, which frequently rubs against the bone beneath the acromion.

Q I am a 58-year-old taxi driver. The pain is so severe that I cannot sleep if I lie on the affected side at night. How can I distinguish between frozen shoulder and a rotator cuff tear?

A. Both cause nocturnal pain, but frozen shoulder involves the stiffness of the joint itself, where the arm cannot be lifted even with assistance. In contrast, a rotator cuff tear allows the arm to be lifted by someone else, but is characterized by weakness when lifting the arm independently or pain at specific angles. An ultrasound or MRI examination is necessary for accurate differentiation.

Q I am a 49-year-old office worker. I am currently undergoing treatment for a partial rotator cuff tear. Are there any foods that help with tendon recovery or foods I should avoid?

A. Protein and Vitamin C are essential for tendon recovery, while Omega-3s found in oily fish help alleviate inflammation. Conversely, alcohol exacerbates inflammation and hinders tissue recovery, so it is advisable to reduce consumption during the treatment period. Diets high in sugary foods and flour can also trigger inflammatory responses, so moderation is necessary.

Q I am a 55-year-old hairdresser. I work with my arms raised all day; aside from movements unavoidable due to my job, are there any specific daily habits that further damage the rotator cuff?

A. Typical examples include sleeping on the painful side, carrying a heavy bag on one shoulder, and suddenly lifting heavy objects by extending the arm. Smoking reduces blood flow to the tendons, making it a major risk factor for the progression of rupture and delayed recovery, while a hunched posture also increases friction between the acromion and the tendons.

Q I am a 57-year-old who runs a small restaurant in Dongincheon. It is difficult for me to leave my shop; typically, how often and for how long should I visit for rotator cuff tear treatment?

A. During the initial inflammatory phase, intensive treatment 2 to 3 times a week is effective, and once the pain subsides, the frequency is gradually reduced to 1 to 2 times a week. The total treatment period is estimated to be 3 to 6 months for partial tears, but the number of visits can be streamlined by structuring the treatment around procedures such as needle acupuncture and pharmacopuncture. A treatment plan tailored to your work schedule is established during the initial consultation.

Q I am a 48-year-old office worker. If I am being treated for a rotator cuff tear at a Korean medicine clinic, in what order is the procedure performed? Is moxibustion performed from the very beginning?

A. Moxibustion is not performed from the start. Typically, after an ultrasound evaluation, inflammation and pain are first managed using acupuncture and pharmacopuncture. Once the pain is under control, moxibustion is applied to areas of adhesion, and fire acupuncture and thread embedding are applied in stages to tissues that are slow to heal. Throughout the entire process, herbal medicine tailored to the patient's constitution is administered concurrently to support the body's recovery.

Q I am a 54-year-old electrician. I have heard that Korean medicine clinics also perform procedures while monitoring with ultrasound. How is this different from simply inserting acupuncture needles?

A. Ultrasound-guided procedures are a method where the location of ruptures, adhesions, and bursitis is directly visualized on a screen, allowing for the precise application of needles or pharmacopuncture to those specific points. Compared to relying solely on fingertip sensation, this method offers a higher hit rate on the lesion and increases safety by avoiding blood vessels and nerves. Another advantage is the ability to track and compare treatment progress using ultrasound.

Q I am a 45-year-old logistics center employee. My tendon is already torn; will getting acupuncture really heal the tear? Honestly, I doubt it is effective.

A. Partial tears often improve with conservative treatment without surgery, and acupuncture helps reduce pain and restore surrounding muscle function. Although the torn tendon is not directly sutured, the goal is to help the shoulder function properly by reducing inflammation and muscle tension around the tear. Surgical consultation may be necessary for full-thickness or extensive tears.

Q I am a 60-year-old self-employed individual. I received two steroid injections at an orthopedic clinic, but the relief was only temporary, and the pain returns. How are needle acupuncture and pharmacopuncture at a Korean medicine clinic different from injections?

A. Steroid injections strongly suppress inflammation to quickly reduce pain, but repeated injections can weaken tendons, so there are limits on the number of times they can be administered. Needle acupuncture physically loosens adhered tissues, while pharmacopuncture and bee venom acupuncture aim to reduce inflammation and aid tissue recovery; thus, their approaches are fundamentally different. These treatments create an environment for recovery rather than simply suppressing pain.