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He has lots of pain.

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If he's in a lot of pain, and there is a good chance of the surgery's being effective, and the risks of the operation are acceptable, then why would you not opt for the surgery? Does your father have other conditions that make him a poor candidate?

Talk it through with your father's surgeon, asking what happens if we do this vs. what happens if we don't do this. There are other treatments and therapies but they are all hard work and/or long, is the trouble.

I don't know if you've ever damaged your shoulder but I have and It Is Miserable - you can't get comfy no matter what you do. As CW points out, a setback like this could not only ruin your father's current quality of life but also put him on a downward spiral.
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I strained and slightly tore a few muscles that make up the rotator cuff last year and it was horrible. However, i'm young and more averse to drugs than to pain. I chose to buy a $30 TENS unit at walgreens and used it for several months. It was the only thing that allowed me to sleep, including the naproxen that I was on.

The way TENS works is that it shoots a tiny electrical current through the uppermost skin, distracting your nerves from the deeper pain. It's very safe and has been used for years. The silicone pad sticks to your skin and can be renewed with some water if it looses its stickiness, for up to 30 uses before it gets thin. The refill pads are about $14 for 4. This is found near the pharmacy near the diabetic supplies or in the pain area near the heat packs (both places). I like the walgreens unit more than the aleve unit because it is smaller than a deck of cards and can power both small pads and large ones, the size of your hand. Aleve's is just a large hand sized unit.
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francee Jan 2019
Thank you very much.
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Ask your doctor about topical Diclofenac Sodium Topical Gel. It is a wonderful anti inflammatory that is applied to the skin and will soak into the joint. It is an amazing topical medication.
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Babs75 Jan 2019
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Which surgery has been recommended- arthroscopic repair or shoulder replacement surgery? They are totally different. The first is done with a few small incisions. The second is significantly more involved.
If they are recommending arthroscopic repair, I might think about exploring this option as something needs to be done or his pain will never improve. I’ve had the arthroscopic repair & it worked, but I had to go to physical therapy the day after and have ROM done where the therapist helped me straighten my arm up above my head the very next day. Yes it hurt!

Of course, he’d need to be cleared by cardiology and any other specialist prior to even having the surgery done. Both procedures require anesthesia which is often detrimental for elderly folks.
You’re in a difficult spot, no doubt. But I don’t know if the way to go is doing nothing.

Try every conservative treatment first -cortisone injections, anti inflammation medications, sling, rest.
After surgery it is imperative he has physical therapy.

Best of luck to the both of you.
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I tore my rotator cuff about 12 years ago. Pt 3 times a week got me to a point it was bearable. A few years later it flared up again, more PT and a cortisone shot. The pain flares up occasionally and I go back in for a OT tune up. The DR said when it gets really bad (like now) I can have another shot. My GF had the surgery and it was brutal, she didn’t get better, and they had to redo it. I will take shots and PT for as long as they work. I would try everything else possible before I subjected a 90 year old person to it.
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A lot depends on his health, if there is nothing but his age that concerns you then I would seriously consider having something done because chronic pain could make the remainder of his life miserable and speed his decline - he wouldn't necessarily need to do as extensive an amount of therapy as a younger person would.
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What kind of health is your father in? Is he active?

My brother just had this surgery & he is only 56. He put the surgery off for Six months, until he could not stand the pain anymore. He couldn’t sleep or function. Today, my 21 year old son had screws put in his leg & I was asking about how painful recovery would be. The Orthopedic surgeon said recovery from that is nothing like recovering from rotor cuff surgery, which is a very painful recovery that takes a while.

How would your Dad’s quality of life be affected either way? Would it be better for him to live long-term in pain or have surgery, recover, & a chance at enjoying life again? Can he tell you what he wants?
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Doctor recommended for mom to see orthopedic doctor for cortisone shot.

She got the shot. Physician said it would take two days for her to feel any relief. Unfortunately, two days later she took a bad fall and was sore from the fall. So who knows if the shot even helped because she was hurting before from shoulder and then from fall. Awful experience.

Taking X-rays was uncomfortable for her too. Hurts so much to see loved ones suffer.

Hope he gets relief soon. My husband who suffered from rotator cuff injury says the pain does not let up and increases to the point of being unbearable. He was 62 so he was a lot younger than your dad and my mom dealing with such a painful condition.
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My mom is 93 and her primary care doctor has already said no surgery for rotator cuff issue. She is in pain. Tylenol Arthritis was recommended for her. Also aspirin cream. Not much relief really. She says her pain is about level 5 - 6.

She was also told ice and heat. Again, not much relief. Mobility is severely affected. Cannot raise arm and hurts if she tries. Has to now wear button down shirts instead of slip on because she can’t lift arm to put on and off.

Dr. Ordered home health which consists of physical, occupational therapy, plus nurse visits. Hope it will help some.

My husband had surgery for rotator cuff and it is brutal! He also had long amount of physical therapy afterward. There isn’t any way in my opinion that someone 90 could handle that. My husband was 62 at surgery and he struggled.

I would not have the surgery. Get another opinion. See what other options may be available.
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My mother tore her rotor cuff at age 71 and did not want a surgical repair. After a few weeks of PT and unrelenting pain she decided to have the surgery but was unable to rehab to a full range of motion. She was never able to raise that arm over her head in full extension again, but, she didn't hurt after the rehab and could raise her arm enough to brush her hair and reach into the second level of her cabinets. Because she had nearly full range of motion in the other shoulder at that time, this was enough to restore a good level of function.

If your dad doesn't have the surgery will he still be able to function using the other arm? Will he be able to put enough pressure on the arm to use a walker or grab bars? Does your dad have any dementia symptoms?

I would be inclined to see what a few weeks of healing and PT can accomplish before risking surgery, particularly if your father has any memory problems at all. My mother had very limited short term memory issues until she had cataract surgery and I now believe the twilight anesthesia used during the cataract surgeries caused the increased problems she began having immediately afterwards. Pain levels will only increase as time passes and the shoulder weakens from non-use, so if your father is in significant pain, then I would probably recommend the surgery, but have a careful consultation with the anesthesiologist about memory/mental function impacting medications.
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A torn rotator cuff is a tear in the tissues connecting the muscles to bone (tendons) around the shoulder joint.
This type of injury often doesn't heal by itself because the tissues don't grow back together. That may mean that your father may be in pain for the rest of his life and have limited movement in that arm.

He could try physical therapy or cortisone injections. I would be very weary using anti inflammatory meds, as they can cause GI bleeding and many elderly people are already talking blood thinners.

If surgery is the only other option to relieve the pain, then of course he will need the pre-op tests to find out if he's physically "up" to having surgery.
What does his general practitioner say?
What does the anasthesiogist say? (They are the ones who have the final say.)
Does your dad want the surgery?
I would suggest you talk to ALL the doctors before you doom your dad to what's left of his life with chronic pain. Doctors, especially these days, aren't into taking risks. They aren't going to operate if EVERYTHING isn't perfect. Maybe they won't have to put him under general anasthesia. That will decrease the risk of post operative complications.


Good luck.
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