Wear and tear of Rotator cuffs is one of the major causes of shoulder pain. Tear may be caused due to an injury or thinning of tissue over age. These tissues are always at work and take long to heal. So, recurrent wear and tear coupled with longer healing time causes further damage. Symptoms may not be universally present across all patients, but they usually appear in 3 phases of progressive damage.

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Freezing: The shoulder becomes progressively more painful without any apparent event. Pain is felt vaguely over the shoulder, over the back, and down the arm. Movement aggravates the pain and causes difficulty in sleeping. The shoulder also becomes gradually stiffer, losing its range of motion. This phase typically lasts between 6 weeks and several months.
Frozen: Here, the joint becomes more and stiffer but the patient may experience some improvement in their pain. This phase typically lasts for approximately 6 months.
Thawing: The stiffness slowly improves. Complete recovery back to normal, or near normal, strength and range of motion takes, on average, 2 years.

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Treatment in such cases is a slow procedure and also approach differs from patient to patient. Every treatment in shoulder pain is to fast-forward patient’s journey through all symptom phases and offer ultimate relief. Non-surgical procedures comprise prescription of anti-inflammatory and analgesic to control inflammation and pain. In cases where non-surgical approach doesn’t seem fruitful, surgery is advisable. Manipulation Under Anesthesia (MUA) involves stretching of the shoulder muscle under general anesthesia, leading to break the scar tissue and thus allowing better and faster movement. But this procedure has its limitations in patients suffering osteoarthritis as it may lead to further damage and breaking of nerve network. In Arthroscopic procedure, the surgeon accurately cuts and removes the thickened scar tissue, enabling improvement in movement.

After the surgery, shoulder sling is advisable to be worn for suggested duration. Also, mild physiotherapy and exercise is recommended to promote quicker rehabilitation to daily routine.