Surgery for rotator cuff disease is no more effective than active non-surgical treatment

Clinical question: 
How effective is surgery for rotator cuff disease?
Bottom line: 
Comparing active non-surgical treatment (physiotherapy or exercise programmes) with surgery for rotator cuff disease showed no significant differences in outcomes such as pain, function and participant evaluation of success. There were also no significant differences in outcomes between arthroscopic and subacromial decompression, although four trials reported earlier recovery with arthroscopic decompression.
Caveat: 
There was insufficient evidence to suggest whether surgery made a difference to other outcomes, such as the ability to use the shoulder normally, quality of life, range of shoulder motion, strength, the likelihood of recurrence, time taken to return to work or sports, and patient satisfaction.
Context: 
Rotator cuff disease is the most common cause of shoulder pain seen by physicians. Shoulder pain is the third most common musculoskeletal reason for seeking medical care after back and neck pain┬╣, and accounts for 1.2% of all general practice encounters in Australia.┬▓ 1. Bott SDM et al. Annals of Rheumatic Disease 2005;64:118-123. 2. Bridges-Webb C et al. Medical Journal of Australia 1992;Supplement 157:51-556.
Review CD#: 
CD005619
PEARLS No: 
75
Date: 
June, 2008
Authored by: 
Brian R McAvoy