Included is the May installment from the Evidence-Based Practice Subcommittee of the American Society of Shoulder and Elbow Therapists contributed by Dr. Mark Kevern.
The article reviewed this month investigated the association between rotator cuff tears and patient-reported pain.
Lifetime prevalence shoulder pain as high as 67% (Luime, 2004) and typically attributed to rotator cuff pathology. Degenerative rotator cuff pathology generally begins around age 50 with steadily increasing prevalence until plateauing at age 80.
The present study found that the prevalence of rotator cuff tears and pain are similar up until age 65 at which point prevalence of pain decreases while degenerative rotator cuff tear prevalence continues to increase.
The authors theorize that rotator cuff tears contributes to pain at certain physical activity levels, and the decreased pain reporting at age 65 may be explained by decreased physical work and leisure demands influenced by retirement.
The authors conclude: “The profile of age-related degenerative rotator cuff disorders fails to correlate systematically with self-reported nontraumatic shoulder pain, particularly in older age; thus, it appears that degeneration should not be considered the primary source of the pain.”
This conclusion is consistent with the findings of Dr. Jed Kuhn and the MOON group who demonstrated 80% of patients with shoulder pain and rotator cuff tears can be treated successfully with non-operative measures particularly physical therapy. Dr. Kuhn Editorial