A recent study in the Lancet journal funded by Arthritis Research UK has found that surgery for sub acromial shoulder pain is no more effective than placebo. Sub acromial pain or impingement as it is often termed is typically responsible for 70% of the shoulder pain reported and is usually painful when reaching overhead and when lifting heavy objects. It can have a profound effect on manual work tasks or household chores and typically affects those over 40-year-old. Standard treatment options include pain medication, physiotherapy, corticosteroid injection or surgical decompression.
Surgery has been used in the treatment of sub-acromial shoulder pain for over 35 years and the number of operations performed has significantly increased over time. Surgery typically involved the cutting of a ligament and the shaving of bone in the shoulder which is reported to reduce the pressure on the rotator cuff tendons. The procedure is followed by a period of work absence ranging from 2-6 weeks.
In this study 313 patients from 32 hospitals in the UK with 51 different surgeons were allocated to either sub acromial decompression, insertion of an arthroscope only or no treatment. The surgical procedure has been questioned for many years and this is the strongest trial to date that shows that surgery is no more effective than simply inserting the arthroscope (placebo) or doing nothing at all.
At Physiotherapy Matters we see a large number of patients with shoulder pain and our results reveal that for sub-acromial pain excellent results can be achieved with conservative treatment programmes based on exercise and probably combined with tape, manual therapy and extracorporeal shockwave therapy.
Clinical Manager Nick Livadas commented:
“The results of this study come as no surprise as it has been a questionable procedure for a number of years. Here at Physiotherapy Matters we frequently are faced with patient with shoulder pain and we discuss with them the varied options of treatment along with the pro’s and con’s of each before making a joint decision. For patients who now ask if surgery will help them we can now discuss the results of this study and hopefully then get patients on track with more simple, less invasive and effective treatment like progressive exercise which can often be combined with taping, hands on therapy and shockwave.”
If you are suffering from shoulder pain and want to arrange an assessment and treatment then one of our skilled physiotherapists can discuss your diagnosis and treatment options before starting you on a course of treatment to alleviate your symptoms. If you are unsure if physiotherapy will help give us a call and we can discuss your case over the phone.
Call us on 0333 220 0238 or visit the website at www.physiotherapymatters.co.uk
The full Lancet study can be accessed here: https://www.sciencedirect.com/science/article/pii/S0140673617324571