A small rotator cuff tear can hurt more than a large one. Small tears cause pain if they're inflamed or in a critical spot. Large tears develop slowly, giving muscles time to adapt and compensate, so they often hurt less.
Bigger rotator cuff tears don't always cause more pain. Pain in the shoulder actually correlates poorly with size. Small tears can be very painful because they're inflamed or they're in an important area biomechanically for the shoulder. Conversely, large tears can happen slowly over time. Tissues adapted and people have compensated from a muscle perspective. So it's not always about the tear size on your MRI. It's about your symptoms and about your function.
