Why a treatment name is not a result
A referral note that says "physiotherapy, then a steroid injection, then arthroscopy" tells a shoulder surgeon almost nothing about your shoulder. It records that events happened. It does not record what the shoulder did afterwards. The receiving team needs to understand the trajectory: was the shoulder getting better, staying the same, or getting worse across those treatments?
Rotator cuff repair reattaches torn tendon to bone, and rehabilitation protects the repair while movement and strength recover. Whether that operation is a reasonable next step depends heavily on what has already been tried and what it achieved. If previous treatment produced a clear, sustained improvement, that is different information from previous treatment that produced nothing, or produced relief that faded within weeks.
This is why the question "what have you already tried?" is really two questions. The first is what was done. The second, and more important, is what changed. Your job in the enquiry is to answer the second question as clearly as the first.
The four dimensions that make a result readable
A useful description of a previous treatment result covers four things: what the symptom was before treatment, what it was after, how long any change lasted, and whether the change was meaningful in daily life. Those four dimensions turn a name into a result.
Take pain. "I had an injection" is a name. "Before the injection, pain at night woke me two or three times; for about six weeks afterwards I slept through, then the night pain returned to roughly its previous level" is a result. The second version tells the team the treatment worked temporarily and then stopped working, which is a different clinical picture from a treatment that never helped at all.
Take movement and strength. "I did physiotherapy" is a name. "Before physiotherapy I could not lift my arm above shoulder height; after twelve sessions I could reach a high shelf, but I still could not carry a shopping bag with that arm" is a result. It separates range of motion from strength, which are not the same problem and do not always recover together.
Take function. This is the dimension that is easy to leave out, and it is the one the receiving team will ask about directly. Can you dress yourself, fasten a bra, reach a seatbelt, sleep on that side, lift a kettle, work? Function is what the operation is ultimately for. A change in function is a result in a way that a change in a scan is not.
Putting previous treatments in order with dates and duration
Sequence matters. A team reading your history wants to know not only what was done but when, in what order, and for how long. Two patients can have identical treatment lists and completely different shoulders depending on whether the treatments were spread over two years or compressed into three months.
Give each previous treatment a rough date or period, and say how long it lasted. "Physiotherapy from about March to June, roughly twice a week" is more useful than "physiotherapy." "One injection, around last September" is more useful than "an injection at some point." You do not need exact dates; approximate months are enough to show the sequence.
Also say who provided each treatment and where, if you know. A course of physiotherapy supervised by a shoulder specialist is different information from a few sessions with a general practitioner, and the receiving team may weigh them differently. You are not being asked to judge which was better; you are being asked to describe what happened so the team can judge.
If treatments overlapped or were stopped early, say so and say why. "I stopped physiotherapy after four sessions because the pain increased" is a result. "I stopped because I moved cities" is a different reason and tells the team the treatment was not actually given a fair trial. Both are worth stating plainly.
Describing what the imaging and reports showed, and what changed since
Previous treatment results include previous investigations. If you had an ultrasound or MRI of the shoulder, the receiving team will want to know what it showed and when it was done. A scan from two years ago and a scan from two months ago may tell different stories, especially if your symptoms have changed in between.
Describe the report in your own words as far as you understand it, and attach the actual images or report if you have them. Do not try to interpret the scan yourself or upgrade a description into a diagnosis. "The report mentioned a tear in the supraspinatus tendon" is enough; the surgeon will read the images. What you can usefully add is whether the scan was done before or after each treatment, so the team can see the timeline.
Say clearly whether your symptoms have changed since the most recent scan or the most recent treatment. A shoulder that has been stable for a year is different from one that has deteriorated over the last two months. If you are not sure, describe what you can do now compared with what you could do a few months ago, and let the team draw conclusions.
If you have had surgery on that shoulder before, describe what you were told was done, when, and what the recovery was like. Previous shoulder surgery is directly relevant to whether a further repair is feasible, and the receiving surgeon will want the operative notes if they exist. If you do not have them, say so rather than guessing at the procedure name.
What the receiving team still has to decide, and what you should not assume
Describing your previous treatment results well does not decide anything. It gives the receiving team the material they need to form a view. Not every rotator cuff tear needs surgery, and not every tear is repairable. Whether repair is appropriate, what type of repair, and what rehabilitation will follow are decisions for the treating surgeon after reviewing your records and, in most cases, examining you.
This is also why you should not read a positive-sounding reply as confirmation of surgery. An initial review can identify what is missing from your file and suggest a next step, but it is not a diagnosis, not a promise of acceptance, and not a decision about your shoulder. The hospital decides suitability.
There are specific things only the treating team can confirm for your case: whether the tear is repairable, whether previous treatments change the surgical plan, what imaging they want repeated or added, and what the rehabilitation will involve. Do not assume that a treatment that failed for you rules out surgery, or that a treatment that helped rules it in. Both are questions for the surgeon.
If your shoulder is getting worse quickly, or you have new weakness, numbness or an injury you cannot explain, that needs local assessment rather than an overseas enquiry. Do not delay necessary care at home while you prepare a file for review abroad.
How to write this up and what to send
You do not need a polished medical document. A short, structured summary in plain English is more useful than a long narrative. Write one paragraph per previous treatment, in date order, covering: what was done, when, for how long, what changed, and how long the change lasted. Then add a short paragraph on your current function and a list of the reports and images you hold.
Keep the first contact brief. A short summary by the enquiry form, email or WhatsApp is enough to start; you can share records after first contact. Do not send passport numbers, card details or a complete medical archive in the first message. The team will tell you what they need next.
When you do send records, send what you have rather than waiting for a perfect file. Missing documents can be discussed and requested; a delayed enquiry helps no one. If you are unsure whether a document is relevant, include it and let the team decide.
A practical next step: write your previous treatment results in the four-dimension format above, attach whatever imaging and reports you hold, and send a brief summary through the enquiry form. An initial enquiry is free and does not require buying a proxy consultation. The team will tell you what is missing and what the relevant next step is for your case.
Sources & scope of this guide
References and official service information relevant to this guide.
This is general planning information and has not been individually reviewed by a doctor. Medical decisions and personal treatment advice come from your treating clinicians.