The mainstay of treatment of rotator cuff tears is physiotherapy. These should target the scapula stabilisers as well as the remainder of the rotator cuff muscles. On occasion physiotherapy exacerbates the pain and is discontinued.
Sub-acromial injections can control the night pain or allow patients to do their physiotherapy exercises. If the injection makes no difference, it is useful to re-evaluate the patient to confirm the diagnosis and exclude differentials. Common differentials include AC joint arthritis (tenderness localized to the AC joint), adhesive capsulitis (lack of external rotation) and cervical nerve root impingement (radiation of pain into the fingers). Ultrasound guided injection can be used to target the area of bursitis.
Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.