Arthroscopic decompression is a minimally invasive shoulder operation to treat shoulder impingement.
What is shoulder impingement and what causes it?
Shoulder impingement is a very common cause of shoulder pain. You feel pain when you lift your arm up both to the side or in front of your body. When a rotator cuff tendon (band of tissue) rubs on adjacent bone and ligament tissue inside your shoulder, shoulder impingement can occur. Your tendon may become inflamed, thickened and worn. The fluid-filled sac between your tendon and acromion, called your bursa, might also become irritated and inflamed.
There are lots of causes of shoulder impingement. They can include:
- Shoulder overuse or wear and tear in sports or repetitive actions that result in a swollen or torn tendon. This might happen in sports such as swimming, tennis, baseball and volleyball, as well as activities such as painting and window washing.
- Bony spurs appear on your shoulder blade and rub against your tendon, causing inflammation and wear.
- The shape of the bones at the top of your shoulder blade (the acromion) can cause chafing on your tendons.
Non-surgical treatments, such as rest, physiotherapy and Cortisone injections may help relieve an impinging shoulder. If symptoms are persistent, your doctor might recommend arthroscopic decompression.
How does shoulder decompression surgery work?
Shoulder decompression surgery aims to relieve compression of your rotator cuff tendons. It increases the space between your rotator cuff tendon and shoulder blade. During surgery, typically two to three small incisions are made around your shoulder. Your surgeon passes a thin and flexible tube with a camera, called an arthroscope, into your shoulder joint. Surgical instruments are inserted and your surgeon can repair any damaged tendons, release a tight ligament and shave away some of your shoulder blade. Shoulder decompression raises the roof of your shoulder to create more room for your rotator cuff tendons to move underneath. Your rotator cuff tendon can then move freely without being rubbed by nearby bone or tissue.
Is shoulder decompression surgery painful?
No, shoulder decompression surgery is not painful. You will not feel any pain during the procedure as you will be given a general anaesthetic or a nerve block injection of local anaesthetic around your shoulder nerves. After shoulder decompression surgery, you may feel some pain. During your recovery, you may need over-the-counter painkillers to manage your pain.
How long does it take to recover from subacromial decompression surgery?
The length of recovery from a subacromial decompression surgery can vary. The time it takes to recover will depend on the extent of your surgery, your physical fitness beforehand, and how well you follow any advice given by your physiotherapist and/or surgeon. You can expect to go back to work after three to four weeks, depending on your job type. You should avoid heavy lifting for one to two weeks after surgery.
You will see one of our knowledgeable physiotherapists who will recommend exercises to improve the movement and strengthen the muscles in your shoulder. It is important that you do these exercises as advised as they will help you to recover faster, improve your shoulder strength and motion, and help to relieve pain. Typically, it will take three to six months to fully recover from arthroscopic decompression surgery.
What happens if shoulder impingement is left untreated?
If left untreated, shoulder impingement can lead to continued inflammation of your tendons, called tendinitis. Swelling of your bursa, called bursitis, can also happen at the same time. Eventually, your rotator cuff tendons will begin to thin and tear.