Downward sloping acromion, bursitis and labral lesion producing shoulder pain

Dear Ask The Doctor: Hi Doc I have been having shoulder pain for the past 12 years. I did 2 years of physical therapy and have had 6 cortisone shots-the pain has gotten worst. I recently did am MRI and the result is: -fraying of the articule fibers of the disaspect of the supraspinatus tendon over a length of 2.0com. This extends in an anterior-posterior dimension for 1.1cm. 1) the acromioclavicular joint reveals capsular thicking along the superior joint line. There is lateral downward sloping to the acromion. A type 2 acromion is present. 2) moderate amount of fluid in the bursa consistent with bursitis. 3) the superior labrum reveals fraying at the base begining at the bicipital labral complex and extending posteriorly. My question is, DO I NEED SURGERY.HELP!

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