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Greetings.The surgical indications are dependent on the following criteria (medical imaging like MRI alone are not the decision maker for the surgery);1) intensity of the pain. If the pain is significant, and does not respond to physical therapy, deep electrotherapy and steroid shots, surgery may be considered.2) restriction of the movement. If the movements do not improve, with the physical therapy, surgery would be needed.3) pain and movements not responding to conservative treatment.4) medical imaging finding like MRI which show significant tear. A small tear usually does not require surgery.Thus if your symptoms are not responding to the conservative measures; despite the small tear, surgery may be necessary. If you have not tried, physical therapy and deep electrotherapy (iontophoresis, phonophoresis, short wave diathermy, electrical stimulation); these would be strongly recommended in slight tear as these are beneficial to resolve the symptoms.Please feel free for your follow up questions.
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