How effective is shoulder surgery for common shoulder pain problems? - Upright Health

How effective is shoulder surgery for common shoulder pain problems?

If you have shoulder pain, you may be seriously considering surgery to correct your problem. And you're probably asking yourself, does shoulder surgery work?

You may have been told that surgery is your best option - or possibly even your only option. While there are certainly people who do end up getting satisfactory results, it's important to know that success with surgery is far from guaranteed.

What are the real success rates of shoulder surgery?

When doing quick online research, you can find claims of up to 90% success for various kinds of shoulder surgery. These numbers would be absolutely fantastic, if they were an accurate reflection of actual patient experience. Due to bias in early studies and short follow up windows, the very high success numbers that were first reported are not very reliable. For many surgeries, there are some short term improvements, but in the long term, surgery often doesn't perform better than properly structured exercise regimens!

Here are a few studies that may interest you:

Dong, W., Goost, H., Lin, X. B., Burger, C., Paul, C., Wang, Z. L.,& Kabir, K. (2015). Treatments for shoulder impingement syndrome: a PRISMA systematic review and network meta-analysis.Medicine, 94(10).

Kondradsen, L.A., Jensen, C.H. (2015) Arthroscopic subacromial decompression results in normal shoulder function after two years in less than 50% of patients. Danish Medical Journal. 62(3). pii: A5026.

Haahr, J. P., Østergaard, S., Dalsgaard, J., Norup, K., Frost, P., Lausen, S., ... & Andersen, J. H. (2005). Exercises versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Annals of the rheumatic diseases, 64(5), 760-764.

Ketola, S., Lehtinen, J., Elo, P., Kortelainen, S., Huhtala, H., & Arnala, I. (2016). No difference in long-term development of rotator cuff rupture and muscle volumes in impingement patients with or without decompression: A randomized MRI study of 140 patients. Acta Orthopaedica, 1-5.J. Kukkonen, A. Joukainen, J. Lehtinen, K. T. Mattila, E. K. J. Tuominen, T. Kauko, V. Äärimaa (2014). Treatment of non-traumatic rotator cuff tears: A randomised controlled trial with one-year clinical results. DOI: 10.1302/0301-620X.96B1.32168

Harris, J. D., Pedroza, A., Jones, G. L., & The MOON (Multicenter Orthopedic Outcomes Network) Shoulder Group. (2012). Predictors of Pain and Function in Patients With Symptomatic, Atraumatic Full-Thickness Rotator Cuff Tears: A Time-Zero Analysis of a Prospective Patient Cohort Enrolled in a Structured Physical Therapy Program. The American Journal of Sports Medicine, 40(2), 359–366. http://doi.org/10.1177/0363546511426003

Brislin, K. J., Field, L. D., & Savoie, F. H. (2007). Complications after arthroscopic rotator cuff repair. Arthroscopy: The Journal of Arthroscopic & Related Surgery, 23(2), 124-128.

Toliopoulos, P., Desmeules, F., Boudreault, J., Roy, J. S., Frémont, P., MacDermid, J. C., & Dionne, C. E. (2014). Efficacy of surgery for rotator cuff tendinopathy: a systematic review. Clinical rheumatology, 33(10), 1373-1383.

Bosma J, Van Engeland MI, Leijdekkers VJ, Vahl AC, Wisselink W. (2010) The influence of choice of therapy on quality of life in patients with neurogenic thoracic outlet syndrome. British Journal of Neurosurgery. doi: 10.3109/02688697.2010.489656.

Altobelli GG, Kudo T, Haas BT, Chandra FA, Moy JL, Ahn SS. (2005). Thoracic outlet syndrome: pattern of clinical success after operative decompression. Journal of Vascular Surgery. 42(1):122-8.

Schwartzberg, R., Reuss, B. L., Burkhart, B. G., Butterfield, M., Wu, J. Y., & McLean, K. W. (2016). High prevalence of superior labral tears diagnosed by MRI in middle-aged patients with asymptomatic shoulders. Orthopaedic journal of sports medicine,4(1), 2325967115623212.

So what can you do if you have shoulder pain and other shoulder related problems?

The most important thing you can do is recognize that exercise may be a viable option for you to handle your own shoulder pain problems. X-rays and MRIs and the pathologies that show up in them are often very misleading, and the muscles that control the shoulder joint are often ignored or improperly trained in conventional approaches.

Many people worry that if they delay surgery, they will never get better. People fear that exercising and can't possibly help and that it may only make things worse. This is one way of looking at it. The other way of seeing the situation is that if proper retraining of the shoulder doesn't work, surgery is always an option that can be attempted later. The effects of surgery, on the other hand, can never be undone and the way you exercise AFTER surgery will always be affected by the surgery.

In a best-case scenario, you gain freedom and range of motion, and you can avoid the trouble, expense, and time off from your life that surgery may entail.

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About the Author

Matt Hsu is a trainer and orthopedic massage therapist. He fought a long battle with chronic pain all over his body and won. He blends the principles he learned in his journey, empirical observations with clients, and relevant research to help others get their lives back.