DEAR DR. DONOHUE: I saw my doctor for a sore right shoulder. I didn’t injure it. The pain came on almost out of the blue as I was reaching for a cup on the upper shelf of the cupboard. I am 62, in good health and take no medicine on a regular basis. The doctor has me scheduled for an ultrasound of the shoulder. He thinks my rotator cuff is torn. What’s involved with that? Is surgery always the treatment? — R.W.

ANSWER: A torn rotator cuff is a royal pain in the shoulder, and it happens at all ages. In younger years, it’s mostly an athletic injury. In the years following midlife, it comes from age-related tissue degeneration.

Four tendons coming from muscles on the shoulder blade compose the rotator cuff. They sweep around the head of the humerus — the upper arm bone — and keep it moored in its socket. They also are responsible for many arm movements.

Shoulder pain is a sign of a large catalog of shoulder troubles. Pain from a torn rotator cuff is often felt on the side of the shoulder and worsens with arm movement and at night. Arm weakness is another sign.

Conservative treatment is warranted for minor tears. Rest of the shoulder is important, but complete rest can lead to a frozen shoulder, something worse than the tear. A frozen shoulder is all but immobile. A pillow under the shoulder eases night pain. Nonsteroidal anti-inflammatory drugs (Aleve, Advil, etc.) are routinely prescribed. Diclofenac, an anti-inflammatory drug, comes as a cream or gel (Voltaren Topical) that is applied to the skin. Physical therapy keeps the shoulder mobile and prevents wasting of arm muscles.

When these conservative treatments fail, when the tear is extensive and frequently when it happens to young athletes, surgery is recommended. The surgery often can be accomplished with small incisions using the assistance of a scope.

DEAR DR. DONOHUE: Our 5-year-old son began to walk quite peculiarly. He said his leg hurt, and he pointed to his upper thigh. We thought it would be a temporary thing, but it lingered for four days. So we took him to the family doctor, who ordered an X-ray. It was normal. The doctor recommended he see a specialist. That doctor obtained a bone scan, which showed Legg-Calve-Perthes disease. Does this heal on its own? He’s not in a cast. — B.P.

ANSWER: Legg-Calve-Perthes disease isn’t a rare disorder, but few people recognize the name. Every year it happens to one in every 1,200 children, mostly between the ages of 3 and 13. That amounts to a large number of kids.

The topmost part of the femur (the thigh bone) loses its blood supply, and the affected bone crumbles. A limp and pain in the upper leg are strongly suggestive of the diagnosis. Early on, X-rays don’t show the changes, but an MRI scan does.

For most, things get better simply by restricting the child’s use of the leg. Sometimes a splint is needed. Surgery is rarely necessary. Later in life, hip arthritis occurs to many who suffered from this in childhood.

DEAR DR. DONOHUE: Can anything be done to stop blushing? From my first years in school up to and including college, I’d blush when I was called on in class. I still blush when I have to give a presentation. I’d like not to. What can I do? — L.B.

ANSWER: We have little control over blushing. It’s a reflex that brings an expansion of facial blood vessels. The rush of blood turns the face red. You suffer from a common anxiety — public speaking. The more you speak in public, the less anxious you’ll get and the less you will blush. That isn’t always true, but anxiety tends to lessen on repeated exposure to the provoking situation.

Ask your doctor if you could use a beta-blocker, a medicine that can quell this sort of reaction. Naldolol or propranolol usually are the ones chosen. You take the medicine about an hour before you have to speak. This isn’t a lifetime of use. It’s to bolster your confidence and is a temporary treatment.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com.

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