Update On Common Shoulder Surgery

A new research review published in the British Journal of Sports Medicine raises questions about the benefits of a commonly performed shoulder surgical procedure when compared to conservative, less risky and expensive treatments....

Subacromial Decompression Surgery (SAD) is commonly performed for the treatment of subacromial pain syndrome (SAPS)-also known as shoulder impingement or rotator cuff disease. The biomechanical basis for this surgery is that pain is caused by bursa irritation and excessive bone formation in the area under the upper part of the shoulder blade, causing impingement/pressure on the rotator cuff tendons. If this is the case, then surgery to correct this, should result in greater pain relief and improved function than treatments that do not correct the biomechanical "problem."

An article published in the latest British Journal of Sports Medicine reviewed multiple research studies which looked at the outcomes related to SAD, a fake (placebo) SAD, and an exercise program. The conclusions from this review were as follows:

1. Compared with placebo surgery, SAD surgery does not provide additional benefits with respect to pain, function or quality of life in adults with subacromial pain syndrome, and probably causes rare serious harms.
2. Compared with exercise therap, SAD surgery probably provides a small, but likely unimportant improvement in pain, and man not improve function in adults with subacromial pain syndrome. 
3. Policymakers, guideline developers, clinicians and patients should reconsider the role of SAD surgery in practice. 

For those of you who have been following my Blog regularly, this should not come as a surprise to you. Many commonly performed surgical procedures are being shown to be no better than a placebo surgery or conservative treatment with physical therapy. 

The main message remains that surgery should be the last resort for most musculoskeletal pain conditions. This new paper adds to the growing evidence that for people with shoulder pain, conservative care can decrease your pain and improve your function without the time away from your meaningful activities (work and play), undergoing expensive procedures, and risking an adverse/serious side effect. 

If you are struggling with shoulder pain, feel free to give me a call to see what your options are. 

Thanks for reading,
​Bob