Considering Shoulder Surgery?
Subacromial pain syndrome (SAPS), also known as rotator cuff disease or shoulder impingement, is a common condition- but is surgery the best approach to treating it? A study published this month in the British Journal of Sport Medicine can help answer this question which comes up a lot in my practice. Although practitioners shouldn’t hang our hat on one study alone, it’s important to evaluate and critique the most current literature and make clinical decisions based on patient-centred care.
If you’re considering shoulder surgery, you should do so based on a thorough cost-benefit analysis. The following types of questions should be asked: what is the recovery time like? What are the risks of surgery? How much can I expect to improve? And, mostly importantly, are there any other options I should try first?
Even though surgery for subacromial pain is a common procedure, studies have failed to demonstrate the benefit of the surgery when compared with exercise as an intervention, revealing that “the surgery probably provides a small but unimportant improvement in pain and may not improve overall shoulder function.” This systematic review also demonstrated with moderate to high certainty that when compared with placebo surgery there was “no additional benefits with respect to pain, function, or quality of life in adults with SAPS and probably causes rare but serious harms.” Therefore, surgery doesn’t necessarily provide the benefits you might assume it does. Bottom line: we should reconsider the role of shoulder decompression surgery in practice.
If you are struggling with a shoulder issue, it’s important to have a thorough assessment done first to figure out the cause of your discomfort. Chiropractors are primary health practitioners and are therefore trained to assess, diagnose, and make recommendations about the best course of action to treat your condition.
- Lähdeoja T, et al. Br J Sports Med 2019;0:1–10. doi:10.1136/bjsports-2018-100486