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UpgradeThe operation is done by keyhole surgery ('arthroscopy'). Sub-acromial decompression involves releasing the ligament from the front of the acromion and trimming off the under surface of the acromion bone. This allows the tendon to move more freely and thus break the cycle of rubbing and swelling. Success following this operation depends upon the ability of the muscle to heal and resume normal activity.
Occasionally the joint involving the outside of your collar bone meeting your shoulder blade can become arthritic. The pain arising from this joint can also be reduced during this keyhole surgery. Please ask your surgeon for the details.
All operations involve an element of risk. We do not wish to over-emphasise them but feel that you should be aware of them before and after your operation. The risks include:
Although you will only have two or three small scars, this procedure can be painful due to the surgery performed inside your shoulder.
Before the operation you may be given a nerve block to reduce pain following surgery. An injection of local anaesthetic is given around the nerves in your shoulder. This usually means that you will not have any feeling or movement in your arm when you awake from the anaesthetic. This may last several hours. When you begin to feel the sensation returning (often a 'pins and needles' feeling), you should start taking the pain medication that you have been given. It is recommended that you take pain medication before full sensation returns. Use medication regularly to begin with, to keep the pain under control. If you require further medication, please visit your General Practitioner (GP). You should take great care of your arm whilst it is numb. You could injure it without being able to feel it. Keep your arm away from sources of heat and cold.
The other common method to reduce pain after surgery involves infiltrating the operated area with local anaesthetic. The effects of this start to wear off a few hours after the operation. Painkillers will then have to be taken.
The sling is for comfort only. You can take it on and off as you wish. You do not need to have your arm strapped to your body. Normally the sling is discarded after a few weeks.
You may find it helpful to wear the sling at night (with or without the body strap) for the first few nights, particularly if you tend to lie on your side. Alternatively you can rest your arm on pillows placed in front of you. If you are lying on your back to sleep you may find placing a thin pillow or small rolled towel under your upper arm will be comfortable.
Yes! You will be shown exercises by the physiotherapist prior to your discharge from the ward and you will need to continue with the exercises once you go home. They aim to stop your shoulder getting stiff and to strengthen the muscles around your shoulder. The early exercises are shown at the back of this booklet.
Usually an outpatient appointment for physiotherapy will be arranged for you in 2-3 weeks time, but it may be earlier than this if your shoulder is stiff. This delay allows the discomfort from the operation to reduce and the healing process to be well under way.
You will usually not have any stitches, only small sticking plaster strips over two small wounds. Keep the wounds dry until they are healed, which is normally within 5-7 days. Usually the dressings will be removed at between 10-14 days by the district nurse or a nurse at your G.P. surgery. You will need to make an appointment at the surgery to have this done. You can wash or shower and use ice packs, but protect the wounds with cling film or a plastic bag.
Avoid using spray deodorant, talcum powder or perfumes near or on the wounds until they are well healed.
This is usually arranged for approximately 6 weeks after your operation to check on your progress. Please discuss any queries or worries you may have when you are at the clinic. Further clinic appointments are made after this as necessary.
The discomfort from the operation will gradually lessen over the first few weeks. You should be able to move your arm comfortably below shoulder height by 2-4 weeks and above shoulder height by 6 weeks.
Normally the operation is done to relieve pain from your shoulder and this usually happens within 6 months (80%-90% of patients). However, there may be improvements for up to 1 year.
This will depend on the type of work you do and the extent of the surgery. If you have a job involving arm movements close to your body you may be able to return within a week. Most people return within a month of the operation but if you have a heavy lifting job or one with sustained overhead arm movements you may require a longer period of rehabilitation. Please discuss this further with the doctors or physiotherapist if you feel unsure.
Your ability to start these activities will be dependent on pain, range of movement and strength that you have in your shoulder. Nothing is forbidden, but it is best to start with short sessions involving little effort and then gradually increase the effort or time for the activity. However, be aware that sustained or powerful overhead movements (e.g. trimming a hedge, some DIY, racket sports etc.) will put stress on the sub-acromial area and may take longer to become comfortable.
You can drive as soon as you feel able. This normally is within a week or two. Check you can manage all the controls and it is advisable to start with short journeys.
In addition check your insurance policy. You may need to inform the insurance company of your operation.
Who to contact if you are worried or require further information?
If your wound changes in appearance, weeps fluid or pus or you feel unwell with a high temperature, contact your GP.
If you have a query about exercises or movements, contact the Physiotherapy department where you are having treatment if you have already started.
We would like to thank the Nuffield Orthopaedic Centre especially Professor Andrew Carr for allowing us to reproduce this information. This has then been modified to suit local patients needs taking into account varying clinical practice. Help and feedback was given from people who have had sub-acromial decompression surgery.
The shoulder is one of the most complex joints in the body. You use this ball and socket joint for throwing and catching, bowling and swinging — and with such vigorous use, it’s no wonder that many people develop shoulder problems.
One Health Group utilises specialist consultants and healthcare managers working together to provide the best possible diagnosis and treatment for our patients.