Shoulder Arthroscopy Surgery vs continuing PT

jj0425

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Hello everyone, I am very happy to have found this community as I am in the middle of a difficult decision and would love some feedback.

I injured my left shoulder back in January 2022. In February, I got a cortisone shot which helped but the pain returned by around May/June so I started physical therapy in July.
I am still in pain so recently got an MRI which showed the following:
“Infraspinatus tendinosis with likely interstitial tear involving the proximal and mid fibers, with mild edema of the infraspinatus myotendinous
junction”

My ortho has recommended arthroscopic shoulder surgery to repair the shoulder. He says since it has been over 6 months and I have tried other methods (painkillers, cortisone shot, PT), he feels surgery is the best option. I am in my 30s so he feels like I should recover well and benefit from many years of a healthy surgery.

I have never had any type of surgery before (except wisdom teeth removal!) so have been feeling a bit anxious. I went for a 2nd opinion just for peace of mind. This new orthopedic surgeon said he would recommend one more cortisone shot and a couple more months of PT before the surgery in hopes it heals on its own. He said if it isn’t healed after that, then move ahead with surgery.

I am not sure what direction to go in. Currently, I can lift my arm above my head although it is sore. It is painful when reaching to the side (ex: grabbing a drink from a table to the left of me) and also very painful when reaching behind (ex: putting on a jacket). It also feels as though my shoulder blade is swollen as when I’m sitting, it feels like there is almost a lump in my shoulder blade area. It is also difficult for me to sleep on my left side. Sometimes I accidentally wake myself up if I roll over. However, I can do normal activties although I probably couldn’t play golf or throw a frisbee with my left hand anytime soon :)

Like I mentioned, I’ve never had surgery so am very nervous about both the procedure and recovery. I do not want to risk making my shoulder any worse. Making it worse is definitely my #1 fear in terms of surgery.

I feel very fortunate that my shoulder isn’t bad enough where all doctors are suggesting surgery but I also am feeling very stressed making this decision. Of course if I could avoid surgery altogether that would be my preference but the thought of going through another cortisone shot and more PT just to possibly need surgery in a few months also isn’t ideal.
Has anyone dealt with a similar situation? Any advice would be so appreciated.
 

Jaycey

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@jj0425 Welcome to BoneSmart! You have come to the right place for support through this journey.

Facing any type of surgery is scary. But you can take comfort in the fact that the success rates for shoulder surgery are very good. Have a read around our shoulder recovery forum. Lots of members happy with the result of their procedure. Don't forget, although surgery is a big deal for you, it's your surgeon's day job!

If it were me, I would go for the surgery versus waiting and more PT. You have already tried that route. If you do opt for another injection you will need to wait at least 3 months before having any surgery.
 

SaraK

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Keep in mind that the surgeon needs to deal with insurance issues. In looking at my visit summaries, the surgeon seemed to use certain buzz phrases to demonstrate the need for the insurance company to approve a surgery. Your initial surgeon can say you tried all of these things and still not resolved so you were wanting surgery. I don't know if the second surgeon can say the same - to him, you may seem uncertain about whether to go with surgery so he needs more evidence before he can file the proper paperwork. If you definitively say "I want the surgery now," that surgeon would probably have the information needed for the paperwork to be approved.

That said, I agree with Jaycey. Unless you are seeing marked improvement still continuing, I'd opt for getting the surgery sooner than later. The sooner you get it done, the sooner your true recovery can begin!
 

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