The People's Perspective on Medicine

Popular Shoulder Surgery Is No Better Than Placebo

Comparing a common shoulder surgery for impingement to sham surgery demonstrated no difference in pain levels after six months.
CC0 https://pixabay.com/en/progress-clinic-medical-care-for-1807543/

As people get older, they may suffer from chronic shoulder pain. Other than a torn rotator cuff, one type of pain is brought on by bone spurs rubbing on soft tissue such as rotator cuff tendons. This condition is termed shoulder impingement, and frequently makes motions like lifting an object off a high shelf very painful. Orthopedic surgeons often recommend shoulder surgery called subacromial decompression for shoulder impingement.

How Well Does This Shoulder Surgery Work?

Arthroscopic surgery allows for minimally invasive removal of the impinging bone. That seems promising, but British researchers wondered how effective it is. They randomly assigned roughly 300 patients with chronic shoulder pain to this type of shoulder surgery, sham surgery or no surgery (Beard et al, The Lancet, Jan 27, 2018).

Six months later, they asked patients about their level of pain. There was no difference between those who had undergone actual surgery or sham surgery.

What Can Patients Do Instead of Shoulder Surgery?

The researchers conclude that their results call into question the value of this popular operation. They suspect that the physical therapy following surgery might have contributed to the benefit patients reported. Instead of shoulder surgery, patients may wish to consider physical therapy, anti-inflammatory medication or topical liniments for pain relief.

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    About the Author
    Terry Graedon, PhD, is a medical anthropologist and co-host of The People’s Pharmacy radio show, co-author of The People’s Pharmacy syndicated newspaper columns and numerous books, and co-founder of The People’s Pharmacy website. Terry taught in the Duke University School of Nursing and was an adjunct assistant professor in the Department of Anthropology. She is a Fellow of the Society of Applied Anthropology. Terry is one of the country's leading authorities on the science behind folk remedies. .
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    I have had recurrent problems with both shoulders over about 15 years. In one case, despite aggressive physical therapy, I was in pain, unable to lift my arm, had trouble sleeping and the problem was getting worse. I read about a book, written by a retired orthopedic surgery, that recommended hanging from a bar. I bought a bar that fit in a doorway. At first I had to lift my arm to the bar and hold my fingers around the bar to grip it and “hang” for just seconds. I gradually gained some range of motion and now am pain free, can hang with both arms, and it literally takes about 30 seconds once or twice a day. The theory is that it opens the area of impingement.

    I think a mention should be made about coffee. My shoulders kill me when I drink too much coffee. I stop, and the pain goes away in less than a wee. I figured it is the bursae that become enlarged.

    I’ve had 9 sessions of Acupuncture with vitamin B -12 shots
    Tried their topical creams etc., all to no avail.
    I do not want surgery. I have suffered lower back surgery with titanium rods and screws inserted in my spine, Also had radio frequency ablations —and still have pain, pain & pain. Where do I go from here ?
    Florida laws restrict the amount of pain killers which is slightly above the strength of aspirin !

    Actually, I am looking for info with regards to ulnar nerve relocation surgery, benefits & potential problems. Any help here?

    I’ve had one shoulder replaced. Asked the orthopedic to do the other one. He said no because of my age and bones (82 and osteoporosis), so I just use ointments and RX. No other choice.

    I had shoulder surgery for a bone spur a little over three months ago. I felt great for about two weeks, and then suddenly the pain returned. I thought that maybe I had strained it by helping a friend move a heavy object, but am now convinced that the surgery was useless. My Dr. now tells me that the only way that I am going to get any real relief is to have shoulder replacement surgery, as the shoulder socket is arthritic! I had a knee replacement two years ago and it was successful, but I am not sure that I want to undergo a total shoulder replacement. I hear that the down time is a lot longer than for other surgeries. I have been seeing my chiropractor, and he has been working with the shoulder, and it seems to be getting better. Some days are better than others, however, and depending on how I move it and in what position, it just about brings me to my knees in pain when I move it the wrong way. I wish I knew the answer, but I am certainly not ready to be cut on again. Any suggestions? Thanks for your program.

    I’ve recently learned that I have a bone spur, which showed up on x-ray. I haven’t had an MRI yet, but I had 15 occupational therapy sessions prior to x-rays, and there was only slight improvement, if any at all. I knew something else must be going on, and that’s why I went to orthopedist and had x-ray. He recommended cortisone injection, which, after a week, has helped with the pain a lot. I still may be facing surgery, though. At least I know that occupational therapy didn’t work. My doctor said he can go in and clean things up, which I want done if the surgery is done arthroscopically. It’s hard for me to believe that removal of a bone spur wouldn’t make a patient feel better. Having something hard like a bone spur removed because it’s pressing on soft tissue should definitely feel better in my mind.

    Has anyone had any success with Acupuncture?

    I had a shoulder impingement and the pain would bring me to my knees just to stretch my arm forward. I had surgery with very successful results. I did not go to a physical therapist, I just followed the instructions given to me by the Dr. My range of motion returned to what it was previously. That was 17 years ago and I have been pain free.

    Many times, a tight rotator cuff muscle, the supraspinatus, has painful trigger points that will only be exacerbated by physical therapy. From my experience, a better course of action is to start with therapeutic massage by a skilled trigger point therapist to release all the trigger points, then only consider physical therapy or surgery if still necessary. If the problem hasn’t been there a long time, trigger point therapy typically reduces the pain level by at least 50% after the first trigger point session and by nearly 100% after an average of 3 sessions.

    * Be nice, and don't over share. View comment policy^