Three clinical studies were carried out in patients with shoulder pain and/or immobility. Simplified, all patients were randomised to an invasive treatment or physiotherapy. The result: Physiotherapy was as effective as any other therapy, including surgery.
Except in the subgroup of patients with a full-thickness rotator cuff tear. In this subgroup of patients, surgery was more effective. How often do we see patients with a full-thickness rotator cuff tear? In the corresponding clinical study, roughly one-quarter of the patients with shoulder pain and/or immobility had a full-thickness rotator cuff tear.
For the great majority of the patients with shoulder pain and/or immobility, less is more. Physiotherapy is as effective as surgery for most patients.