Rotator Cuff Tear: Causes, Symptoms, and Treatment
Medically reviewed by Sumiran Racherla, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Rotator Cuff Tear?
An orthopaedic surgeon, a doctor who treats problems of the bones, joints, muscles, and tendons, usually treats rotator cuff tears. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is a rotator cuff tear?
A rotator cuff tear is a common cause of shoulder pain and disability among adults. The rotator cuff is a group of four muscles. They come together as tendons to form a covering around the head of the humerus, the upper arm bone. In a tear, one or more of these tendons becomes partly or completely detached from the head of the humerus.
There are different types of tears:
- A partial tear does not completely detach the tendon from the bone. The tear goes only partway through the thickness of the tendon.
- A full-thickness tear detaches part or all of the tendon from the bone. With a complete tear, there is essentially a hole in the tendon.
Symptoms
The most common symptoms of a rotator cuff tear include:
- Pain at rest and at night, especially if you are lying on the affected shoulder.
- Pain when lifting and lowering your arm or with specific movements.
- Weakness when lifting or rotating your arm.
- A crackling feeling, called crepitus, when moving your shoulder in certain positions.
A tear that happens suddenly, such as from a fall, usually causes intense pain. There may be a snapping feeling and immediate weakness in your upper arm. Some rotator cuff tears are not painful, but they may still cause arm weakness and other symptoms.
Causes and who gets it
There are two main causes of rotator cuff tears: injury and wear. You can tear your rotator cuff if you fall on an outstretched arm or lift something too heavy with a jerking motion. Most tears come from the tendon wearing down slowly over time. This happens naturally as we age and in most cases is relatively painless.
Repeating the same shoulder motions can stress the rotator cuff. Baseball, tennis, rowing, and weightlifting can put you at risk for overuse tears. People over 40 are at greater risk. Painters, carpenters, and others who do overhead work also have a greater chance for tears.
How doctors diagnose it
Your doctor will ask about your symptoms and medical history and then examine your shoulder. They will move your arm in several directions to check your range of motion and test your arm strength.
- X-rays are usually the first imaging test. They show bones but not soft tissues like the rotator cuff. They are used to look for other reasons for shoulder pain, such as arthritis.
- An MRI or an ultrasound can show the location and size of the tear. An MRI also gives your doctor a better idea of how old or new the tear is.
Treatment
The goal of treatment is to reduce pain and restore function. In about 80 to 85% of patients, nonsurgical treatment relieves pain and improves function in the shoulder. Nonsurgical options may include:
- Rest and limiting overhead activities.
- Anti-inflammatory medicines such as ibuprofen and naproxen, which can reduce pain and swelling.
- Strengthening exercises and physical therapy to restore movement and strengthen your shoulder.
- A steroid (cortisone) injection if rest, medicines, and physical therapy do not relieve your pain. It does not work for everyone. Repeated, long-term injections have potential risks.
Most tears cannot heal on their own. But you can often get good function without surgery because many other muscles and tendons help move the arm.
Your doctor may recommend surgery if your pain does not improve with nonsurgical methods. Surgery may also be a good option in other cases. These include symptoms that have lasted 6 to 12 months, significant weakness and loss of function in your shoulder, or a tear from a recent, acute injury. Surgery most often re-attaches the tendon to the head of the humerus. Repairs are usually done arthroscopically, with small cuts. An open procedure can be done if necessary. The major risks of surgery include infection, permanent stiffness, anesthesia complications, and a risk that the tendon tears again.
When to see a doctor
If your arm feels weak right after a sudden injury to your shoulder, see your provider as soon as possible. Chronic shoulder and arm pain are also good reasons to see your doctor.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. A direct primary care doctor can examine your shoulder, review your symptoms, and refer you to an orthopaedic surgeon or physical therapist when needed.
Common questions
Can a rotator cuff tear heal on its own?
Most rotator cuff tears cannot heal on their own, but you can often get good function without surgery. This is because many other muscles and tendons help move the arm.
Do all rotator cuff tears cause pain?
No, some rotator cuff tears are not painful. They may still cause arm weakness and other symptoms.
Does a rotator cuff tear always need surgery?
No, nonsurgical treatment relieves pain and improves function in about 80 to 85% of patients.
Sources
- American Academy of Orthopaedic Surgeons - OrthoInfo - Rotator Cuff Tears
- American Academy of Orthopaedic Surgeons - OrthoInfo - Rotator Cuff Tears: Frequently Asked Questions
- MedlinePlus - Rotator Cuff Injuries
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
