Surgical Options
If all the self-help and non-surgical treatments fail to improve your symptoms you may be referred to the Orthopaedic service for a surgical opinion.
For Rotator cuff related pain
Sometimes, if your pain is caused by some impingement of the bone at the top of your shoulder on the soft tissues an operation called a sub-acromial decompression can be effective. Your surgeon will look into the area called the sub-acromial space within your shoulder via an arthroscope (a small camera). They’ll insert specially designed surgical instruments to cut and improve the space in the area.
However, recent research has shown that surgery is not needed as much as previously thought. In addition people who complete a programme of exercises recover just as well as people who have had surgery and this improvement is maintained for up to 10 years.
You should be aware that if your pain is constant and caused by tendinopathy then surgery is unlikely to help this.
Depending on the amount of work that has been done by the surgeon recovery time can take from 6 weeks to 3 months, but some individuals do take longer to recover.
All people having surgery will still need to go through a rehabilitation exercise programme.
Rotator cuff tendon tears
Occasionally, these tendons can completely tear. In a younger person with a clear history of injury they may need surgical repair. However even in this case rehabilitation still has a vital role.
Unfortunately, if all of the rotator cuff has completely torn (a massive rotator cuff tear), repair of these tendons is not always possible, especially in an older person.
If rehabilitation and conservative management is ineffective in this case, then the option may be a type of shoulder replacement called a reverse shoulder replacement.
Osteoarthritis of the shoulder (ball and socket) joint
For severe arthritis of the shoulder joint, the surgical option would be a complete shoulder replacement. This surgery can only be done if the rotator cuff tendons are working normally.
This surgery is mainly done for pain relief. After this surgery it is very unlikely that you will regain full movement with your arm above your head.
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