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Subacromial pain iacounts for up to 70% of shoulder pain. Patients may be diagnosed with subacromial pain syndrome (SAPS), shoulder impingement, or rotator cuff disease and often end up in surgery.
This new guideline states that subacromial decompression surgery should not be offered to patients with subacromial pain syndrome. The guidance — considered a strong recommendation — applies to patients with atraumatic shoulder pain, including rotator cuff disease, lasting longer than 3 months.
The guideline comes from the BMJ's Rapid Recommendations panel made up of patients, clinicians, and researchers.
The recommendation was based on findings from seven randomized trials among roughly 1000 patients that compared decompression surgery with either sham surgery or exercise alone.
Overall, decompression surgery did not provide a meaningful benefit over nonsurgical treatment in terms of pain, function, or quality-of-life.
Conversely, surgery was associated with more cases of frozen shoulder (12 excess cases per 1000 surgery patients).