Having treated a few of these, pre and post op, physio can as noted improve control, core and strength but cannot fix the tear. They either settle for a bit then recur with increased activity or just grumble away.

Results from surgery have been good and as prev. post mentioned alleviate the problem.

If you look at it like the cartilage in your knee .... if it does not settle with rest and the right advice / treatment / exercises and you have a scan with positive diagnosis ....what would you do? See a surgeon, even for an opinion.

Good luck.