Surgery for a full-thickness rotator cuff tear should be considered for several reasons:

1. Improved Function:  A full-thickness tear often leads to significant functional impairment. Surgery can restore the normal anatomy of the rotator cuff, improving shoulder strength and range of motion.
2. Pain Relief:  Many patients with full-thickness tears experience chronic pain. Surgery can alleviate this pain, leading to a better quality of life.
3. Preventing Further Damage:  Over time, a full-thickness tear can lead to the degeneration of the shoulder joint and muscles, potentially causing further damage and more complex problems. Early surgical intervention can prevent these complications.  Problems that can arise are muscle atrophy (where the muscle turns into fat and fibrous tissue).  Atrophy is irreversible once this happens.  Also larger tears can lead to rotator cuff arthropathy with breakdown of the cartilage of the shoulder joint.  
4. Failed Conservative Treatment:  If non-surgical treatments (such as physical therapy, medications, and injections) do not relieve symptoms, surgery may be necessary to address the underlying issue directly.  This is the first line of treatment for partial rotator cuff tears which have less of a chance of increasing in size.  For full thickness tears in younger people, surgery is the optimal option.  
5. Athletes and Active Individuals:  For those who need to return to high levels of physical activity, surgery may offer the best chance for a full recovery and return to pre-injury levels of performance.
6. Age and Tear Characteristics:  Younger patients and those with larger or more severe tears may benefit more from surgical repair to optimize long-term outcomes.

Each case is unique, and the decision to proceed with surgery should be based on a comprehensive evaluation by an orthopedic specialist, considering the patient’s specific condition, activity level, overall health, and personal goals.  At Total Orthopedics and Sports Medicine we have specialists who can evaluate your rotator cuff tear problem and come up with a treatment plan specific to yourself.