Partially torn bicep and rotator cuff - surgery needed?

[Manuel]

Not a Dr...

I would try PT first and see how it does during the coming months.    If your tendon is not fully torn you dont have danger it will shrink and the operation be more difficult.

MRI's are not 100% accurate, could be less or more torn.   My Dr. said in my case you need to be operated.
I tried PT and feel 95% good but it took some 6 months to be at 80% would say.

Main thing now for you is to take care and not tear it all the way I would say.

Good luck.

[cuda hunter]

Being a home builder I have seen many rotator cuff injuries over the years.  A lot of good men don't work construction any longer due to rotators.  It's my biggest worry on the jobsite.

I have a few scary stories.
  My best friend tried to catch a product falling off the work truck.  Tore his rotator cuff.  Had one surgery, paid for, didn't recover.  Said the pain was so great he couldn't think properly.  He went in again and went under the knife.  Paid for by insurance.  Came out of surgery, did his PT.  Never properly recovered.
  He lost his house, his wife, his 35 years professional mechanics tools, his cars.  He basically lost it all as he could not sit in the passengers side of a modern car for more than 20 minutes.  He lost it all.   Now I can't even get ahold of my best friend as he can't afford a phone payment and lives in a bus on some crappy land in the middle of nowhere, waiting to die.  Very very unfortunate. 

  Another good friend of mine, tore his rotator cuff.  The docs said it would be difficult to repair and they opted to "burn" the nerves to deaden the pain.  They burned it once and his pain did not go away.  They went in again and deadened the nerves to only make the pain worse.  That friend has now lost everything as well.  Wife, house, kids, motorcycles, his ford truck.  I saw him not too long ago and he could barely remember my name.  He said the pain is so great that he contemplates suicide daily.  He's lost everything and the pain is literally driving him crazy.

  Now, my partner of about 20 years tore his rotator cuff at work.  He went to Mexico.  Got a 4500 dollar surgery, which was quoted at over 60K here in America.  He found a mexican doctor that works in USA half the year and mesico the other half.  He had the carbon screws put in his cuffs and he recovered to 95%.  He doesn't do construction any longer as that was his retirement but he does fix motorcycles now.  He moved to mexico as the cost of living is so much lower there.  After he had to retire as a construction worker he didn't really have much of an option.  He swears by mexico.  typical hippie.  Anyway, he recovered well.  Which is surprising for mexico doctors.  He had dental work done down there that didn't stand the test of time, but his rotator cuffs recovered.  And he didn't have to literally go broke to fix his arm. 

[MKA]

This stuff is good for pain and swelling relief.  Apply overnight.  Works that night and next day.   Pricey but I use it all the time and the 32 ounce jug can last 6 months or more.   They have smaller sizes for trial.   

https://www.amazon.com/Biofreeze-Arthritis-Reliever-Analgesic-Original/dp/B002J9HBY8/ref=sxts_rp_s_a1_0?crid=I9JKIIS76QYD&cv_ct_cx=biofreeze&keywords=biofreeze&pd_rd_i=B002J9HBY8&pd_rd_r=52739589-e869-4be3-8895-5c829a76cc11&pd_rd_w=4B5UU&pd_rd_wg=ftccR&pf_rd_p=417cc47b-0c09-4851-92d2-3088b503e056&pf_rd_r=DM4R010SPS02753X3Q56&psc=1&qid=1641053783&sprefix=Biofree%2Caps%2C126&sr=1-1-5985efba-8948-4f09-9122-d605505c9d1e

[torredcuda]

MRI results -

[YYZ]

It should go without saying to listen to your doctor first, and if you have concerns, get a second opinion.

Since it does not appear that you have a full-thickness tear (completely or almost completely severed) conservative treatment such as physio is likely the best start.  The bone spur concerns me, but that's a fairly minor procedure if your doctor determines that it needs to be smoothed out.

Most people, especially active males, will have some minor tears and wear in the rotator cuffs by the time that they reach middle age.

If the surgery is recommended, then make sure that you do your homework with respect to getting a good surgeon, a good facility, and appropriate after-care.

Good pain management strategy is also very important.  As @cuda hunter 's friend experienced, my first operation and the recovery was the single most physically painful thing I've ever had to endure.  More so than broken ribs, multiple broken bones, getting kicked in the jewels, etc.  It is, however, better now.  Knowing what to expect and being able to plan ahead really helped with pain management and recovery for the other shoulder.

[torredcuda]

When the nurse was prepping me for the injection he said it would hurt a little an asked how my tolerance for pain was, I told him I`ve been thru two herniated discs (excruiatingly painfull) and a bad divorce(different kind of pain) so I can handle it just fine