SLAP tears in the shoulder affect the cartilage and the joint. It is a common overusage injury and causes an aching pain in your affected shoulder. The connective tissue surrounding the cartilage gets injured, and the joint’s stability is suddenly lost. Common causes are wear and tear of the articulation or an acute injury. But many patients ask if there’s a way to treat this type of injury without surgery. Let us find out after reviewing the scientific literature.
Is surgery the best treatment for a SLAP tear?
Surgery is not the first-line treatment for SLAP tears unless they are severe. In patients with mild to moderate symptoms, physical therapy and other alternative treatments are often enough to improve the quality of life and range of movement of the articulation. So, there is a treatment for SLAP tear without surgery, but keep in mind that this treatment is only meant to improve the symptoms and won’t heal the injury. When symptoms are not improved after 6 to 12 weeks with alternative measures, surgery is a must.
Surgery is the only way to heal a SLAP tear that’s entirely off the bone, and in case you have one of the following conditions:
- If you’re an older patient
- If you have bone spurs, which are bone growths that make the joint structure irregular
- If your range of movement becomes severely limited or end up with chronic shoulder pain
- If you have an additional rotator cuff tear
What happens if you do not treat a SLAP tear?
Mild and moderate SLAP tears may not need surgery, but they do need treatment. You’re wrong if you decide not to do either one of them, hoping that it will heal by itself. Instead of improving over time, a non-treated SLAP tear will severely affect your mobility, range of movement, strength, and other traits. These may not become visible right away, but they will gradually increase and become a functional limitation.
Patients who do not treat this type of injury often come to the doctor with chronic shoulder pain, muscle weakness, and muscle wasting in the affected arm, stiffness, and a process of joint degeneration that may be difficult and sometimes impossible to fix entirely.
Keep in mind that, even though some SLAP tears can be treated without surgery, all of them should be evaluated by a doctor. Patients should not take the approach of “wait and see” or neglect their condition until they have severe movement limitations. If you have a suspicion that there’s a SLAP injury on your shoulder, do not hesitate and come immediately to the doctor.
Suitable treatment options without surgery
You could need surgery or not, depending on the severity and the location of your SLAP injury. But in most cases, non-surgical therapy is the first-line treatment, and many patients respond favorably to one of these treatments or a combination:
- Physical therapy: It is fundamental in any part of the treatment and is also required for patients who underwent surgery. It is the first method typically employed in these patients. The goal is to reinforce the articulation by strengthening the arm muscles. Simultaneously, physical therapy helps to maintain the range of movement and prevents stiffness and other limitations.
In most cases, doctors recommend 3 months of physical therapy as a minimum. If you still have severe symptoms, you may need to undergo surgery. Responding well to this type of treatment is a good sign, but do not pretend to be okay just because you want to avoid surgery. If you read above, you now know that leaving this type of lesion untreated (or half-treated) is not a good idea.
- Steroid injections: The most common steroid injected into the articulation is cortisone. It is a type of steroid with a potent anti-inflammatory potential, and the main goal is reducing the perception of pain. By reducing pain, you will feel better and perform well in your physical therapy sessions. Therefore, it is commonly used in association with this type of intervention.
You won’t need steroid injections every day or every week. Each application lasts for a very long time. However, at the time of application, it is uncomfortable and frightening for some. At the end of the day, it’s worth it because you will have a pain-free recovery and improve your condition faster.
- Pain-relieving drugs: In some cases, pain-relieving drugs are administered between steroid injections to increase the anti-inflammatory potential if you have severe symptoms. In patients with very mild symptoms, pain-relieving drugs can be administered instead of steroid injections and combined with physical therapy.
These drugs work exactly the same as common over-the-counter drugs, and most of them are non-steroidal anti-inflammatory drugs.
Remember that you may still need surgery if you still have the same symptoms after rehabilitation, have a partial recovery, or feel worse than you felt at the time of diagnosis.
SLAP tear treatment does require surgery to heal fully. However, most patients with mild or moderate injuries do not need surgery to regain their range of movement and functional ability. In these cases, a combination of physical therapy and pain-relieving medications or injections can be enough to rehabilitate the affected limb and improve patients’ quality of life without surgery.
Do not neglect your condition and let your doctor evaluate you and recommend the best treatment for your particular case. In most cases, he may want to try non-surgical treatment first, unless you have a very severe SLAP tear that won’t definitely improve with physical therapy alone.
Cvetanovich, G. L., Gowd, A. K., Agarwalla, A., Forsythe, B., Romeo, A. A., & Verma, N. N. (2019). Trends in the management of isolated SLAP tears in the United States. Orthopedic journal of sports medicine, 7(3), 2325967119833997.
Varacallo, M., Tapscott, D. C., & Mair, S. D. (2020). Superior Labrum Anterior Posterior (SLAP) Lesions. In StatPearls [Internet]. StatPearls Publishing.
Knesek, M., Skendzel, J. G., Dines, J. S., Altchek, D. W., Allen, A. A., & Bedi, A. (2013). Diagnosis and management of superior labral anterior posterior tears in throwing athletes. The American journal of sports medicine, 41(2), 444-460.