Problems After Subacromial Decompression Surgery

by Martin
(Aarhus, Denmark.)

I've read your excellent article - however it failed to mention side effects after this procedure.

I have had this surgical procedure done - removing the subacromial bursa. However, I have found that this has given me some other problems after surgery. I am not a doctor but I have educated myself on the anatomy of the shoulder joint and it would seem that the biceps nerve which goes through the shoulder joint is somehow scraping against the acromion - now that there is no bursa to smooth things out.

Could you maybe point me some directions on any articles or material that describes any possible side effects of this surgery?

I am trying to educate myself, since I have found that most doctors unfortunately treat people like myself with legitimate questions as either hypochondriacs or they are too arrogant to really listen to a non-doctor trying to figure out what the hell went wrong.

Regards,
Martin

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Problems After Subacromial Decompression Surgery

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Aug 08, 2008
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Biceps tendon?
by: Bart - SII

Hi Martin - I think you must have meant the biceps tendon (biceps longhead) which does run through the shoulder joint between the humerus and the acromion - the nerves of the brachial plexus and upper extremity all run anterior or inferior of the humerus and course through the axilla on their way to the arm.

You are right, there isn't as much padding to prevent impingement of the soft tissues of the shoulder on the acromion - however, there is more space in the subacromial space, so you should have less impingement.

The key to this surgery working is re-establishing good muscle control to keep the humeral head centered on the glenoid and avoid excessive riding up onto the acromion.

After surgery you should be focusing on improving your shoulder strength, but also the strength of the muscles in your upper back.

The most commonly seen problems after a subacromial decompression surgery are

Loss of range of motion or inability to fully regain all shoulder motion, decreased strength, continued pain, pain at night, increased pain with weather changes.

Most of these problems are alleviated with proper rehabilitation following surgery.

hope this helps - comment back with other questions

Feb 16, 2009
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Bicep Pain after subacromial decompression
by: Cathey

Martin -

How long since your surgery? Mine has been about 5 weeks and my bicep pain has not improved. My surgeon insists it has nothing to do with my surgery; however, it was not there before surgery and is intolerable now. I am having increased trouble sleeping due to the pain and discomfort.

Any recommendations?

Apr 05, 2009
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to martin
by: dani

I hear you on how doctors treat us...dang. I'm one year since my injury &10 months since surgery. I have constant pain. Guess I'll never be able to hook a real bra again. Can not get my arm behind my back past my waist. My shoulder blade area hurts constantly, & believe it or not, the worst time is when I eat> What"s up with that? Therapist sez maybe injury in back or neck? xrays show nothing. Cold weather is hell. Why's that? It is the pits & I just came on your site, trying to find some answers. Well, not your site, but boy did I understand what you were saying. Best of luck in recovery, Dani

Apr 29, 2009
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Glenoid fracture
by: Jeff Hubbs

I had a glenoid fracture, recieved therapy and am still having pain after two years. I have two pins in my shoulder I cannot sleep seeing as it is 0300 hr's here in Illinois. I was knocked off a ladder it has effected my sleep my sex life and everything I am tired of Narcotics for pain I have gained 70 lbs from not being able to work out and still have pain. what can I do

May 01, 2009
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Had both shoulders operated on
by: Donna

I'm glad I am not the only one. I had subacromial decompressions and debriement on both of my shoulders following a cervical fusion of the C5/C6 five months prior to them. Shortly after my cervical fusion I developed pain in both of my upper arms...it was bad, could barely lift my arms from the pain. I had the shoulder surgeries done 6 weeks a part. The first surgery was 3/08 and the 2nd at the end of 4/08. I am still in PT, still taking anti-inflammatories which are eating up my stomach, and still in pain. Although the original pain has improved, the new pain seems to be worse. I have been getting trigger point injections with minimal success. I too would love to have my life back.

Jun 15, 2009
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glad i had the op
by: Anonymous

i had my first surgery just over a week ago, it was hell and first and i thought no way was i having the other done, but now a week on from my op the only thing bugging me is my stitches as i had open surgery on it, i can now reach up my back still struggling at lifting my arm up but the pain is so much better then before my op.

Jul 18, 2009
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not encouraging
by: jaxx

I this surgery July 2 and i can't tell if my pain is coming from insertion points of the tools (they did grind through my arm to get inside), or from the bursa sack removal and bone smoothing. it seems the top of my bicep right below incision sites hurts just from the pressure of placing my hand over my muscles. i do my exercises every day and after 2 wks (maybe still too early( it feels tight and i can't lift it up much without pain.

i was told most people with this surgery do at home rehab w/ pulleys but i think i'm going to head over to rehab with people who might actually know what they're doing. i don't want to not work it enough and never get my range of movement back.

is anyone sleeping on their shoulder after a year?

Jul 18, 2009
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Sleeping on Shoulders
by: Donna

It has been almost 1 1/2 years since I had both shoulders done and I am just starting to sleep on my shoulders, but not without pain and discomfort. I can fall asleep sometimes on my side but it almost always wakes me up with pain and I have to roll over. Even sleeping on my back causes discomfort because your shoulders drop back. If you use a thin pillow and just lay it under your upper arm it will really help.

I wouldn't try sleeping on your side just yet because you will only aggreviate it and make for a miserable day the next day.

There are still many things I cannot do because I don't have the strengh back - due to set backs in PT. Everytime I got passed the stretching exercises and tried to move on to strengthen they would flare up and usually caused me having to go back on steriods.

Finally after 1 1/2 years I am doing strengthening exercises to strengthen my upper back. It is slow going but after switching PT places I am making improvement and feel soon I will see the light at the end of the tunnel.

Whatever you do - do not do anything while holding your arms over your head for quite sometime. I am told this will surely aggreviate and damper you progress.

Donna

Jul 18, 2009
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When will the bursa come back
by: jaxx

I was told the bursa sack would rejuvenate itself and come back. How long does this take? Without it, aren't we more prone to tear our rotator cuff muscles?

Jul 18, 2009
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Bursa Sac Growth
by: Donna

I don't recall the surgeon stating that it would grow back. I thought when they shaved the acronim that was to free up some space so everything would glide better. I certainly hope mine doesn't grow back...I don't ever want to go through this again.

Donna

Jul 18, 2009
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RE: Bursa
by: jaxx

I do believe some of it will grow back. I'll try and find a good source. Bursa itself is not the issue.. you want this to protect your tendons and rotator cuff muscles from rubbing against bone and tearing/fraying. Inflamed bursa is the problem and what causes pain (less room for muscles to move around). I have a follow up appt. coming up, I'll confirm some things and post them.

Sep 03, 2009
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Subacromial Decompression Surgery
by: jake regan, england

i had Subacromial Decompression Surgery to my left shoulder 18 months ago. it hurt for about 3 months after and i was worried that the operation hadnt worked.After physio and rehab it seemed to be much better.about 3 weeks ago it started to ache alot and i wondered what i had done wrong.I dont remember having an accident or bumping it.I have been taking a ibuprofen gel anti inflamitory 3 times a aday but it hasnt helped.what should i do?

Sep 03, 2009
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To the poster above
by: Jaxx

My surgery was two months ago, at what point did your shoulder feel better (before it started to hurt again)? I put pressure on it last Friday and it went "POP". I've been in a lot of pain since, and my movement is back to where it was a few days after surgery. Pain too.

Before last Friday it was feeling much better, and my movement was great (for two months out).

Are you icing it?

Sep 16, 2009
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No Problem Here
by: Baseball9

I had my right shoulder done on halloween in 2007 and it feels great now. It took me about 2 months before I could sleep in my own bed comfortably. Also, After my surgery I was told I wouldn't be able to throw a baseball until late January of 08 but I worked hard at my rehab and was tossing a ball 4 days before Christmas. My shoulder healed up nicely and I haven't had a problem with it. I am now going to have my left shoulder done in 2 weeks and I hope I have as much good luck with it as I did my right one.

Sep 22, 2009
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still frozen
by: zabrina

i had the decompression surgery w/ removal of bone spur and manipulation on july 20 2009 i have been in physical therapy every sinse and i have had another steroid shot as well sinse surgery and my shoulder still is frozen and week i have a little less mobility than what i had before surgery i dont have a lot of pain or inflamation prior to surgery i had 20 weeks of p therapy and a steroid shot nothing frees it up what can else can be done anything or am i just stuck with this condition permnantley

Sep 22, 2009
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still frozen
by: zabrina

i have had 26 weeks of physical therapy 2 steroid shots and subcromial decompression surgery that i had on july 20 2009 and my shoulder is still frozen i have no better mobility than what i had before surgery i have missed almost three months of work can they do anything else for me or is this it?

Oct 26, 2009
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Subacromial smoothing
by: Sharon Hunt

I had Subacromial smoothing surgery on 9-14. I started physical therapy the week after. The PT was uncomfortable, but not unbearable. Last week my shoulder started to hurt so bad that it brings me to tears several times a day. I can't imagine living like this. I am wondering if the pt and home exercise program is too much. I am desperate for relief and answers. Is there anyone out there that had this surgery performed, had a LOT of pain, but got better eventually? I would LOVE some words of encouragement.

Thank you.

Oct 28, 2009
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Response to Sharon
by: Donna

Hi Sharon,

I had both shoulders done (you can read my previous posts with issues). It has been about 1 1/2 years since my surgeries and just in the last month or more have I finally gotten some relief. I had a lot of flare ups with PT trying to find the right balance of stretching and strenghten. My doctor told me not to do too much because it can set you back in pain. You have to keep it moving though or you will have pain, but it takes a lot of patiences. I know it is very frustrating. I still have difficulties sleeping on my sides, but the pain has lessen. The turning point for me was seeking a second opinion on the pain and starting with a new PT person. They concentrated on releasing the knots that had accumlated. Good luck...hang in there.
Donna

Oct 31, 2009
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Problems after subacromial decompressions surgery
by: Sharon Hunt

Hi Donna,

Thank you so much for writing. I am returning to work on Monday and am in a near panic in trying to figure out how I am going to work and deal with my pain too. A year and a half is a LONG time Donna.... I feel so bad for you as I know exactly what you have been going through. BUT, by you saying that you are finally feeling better, has given me a little bit of light down that very long tunnel to look forward to. Your comment about finding a PT to work out the knots hit home with me. I had been thinking that one of the main things that has been causing me so much pain was my spasming muscles, and I was thinking that I would start paying someone to massage my shoulder a couple of times a week. The doctor keeps saying, "stretch, stretch, stretch," and my PT does work on this during my sessions, along with a little bit of massage, followed by several exercises in the gym. They do tell me to stop if any particular exercise causing me a lot of pain. When I try and stretch my arm at home, it causes me SO MUCH pain that I have to stop. I don't want my shoulder to "freeze up," but it feels the best when I don't push things. Please keep me posted as to your progress and any "tips" you might have. I will do the same. You can email me directly at "theorchardhouse@verizon.net" Take Care!Sharon

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Oct 31, 2009
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Submitted by: Sharon Hunt

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Hi Donna, Thank you so much for writing. I am returning to work on Monday and am in a near panic in trying to figure out how I am going to work and deal with my pain too. A year and a half is a LONG time Donna.... I feel so bad for you as I know exactly what you have been going through. BUT, by you saying that you are finally feeling better, has given me a little bit of light down that very long tunnel to look forward to. Your comment about finding a PT to work out the knots hit home with me. I had been thinking that one of the main things that has been causing me so much pain was my spasming muscles, and I was thinking that I would start paying someone to massage my shoulder a couple of times a week. The doctor keeps saying, "stretch, stretch, stretch," and my PT does work on this during my sessions, along with a little bit of massage, followed by several exercises in the gym. They do tell me to stop if any particular exercise causing me a lot of pain. When I try and stretch my arm at home, it causes me SO MUCH pain that I have to stop. I don't want my shoulder to "freeze up," but it feels the best when I don't push things. Please keep me posted as to your progress and any "tips" you might have. I will do the same. You can email me directly at "theorchardhouse@verizon.net" Take Care!Sharon

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Nov 07, 2009
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sub decompresion
by: ivor

i had my shoulder op on 16.10.09 after a fall last year made it intolerable.since the op i have difficulty in moving the muscles in my arm and sleeping on my side.given the choice i would not go through it again.i was not told about any side effects by any medical personelle.shame on them.

Nov 10, 2009
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This is tougher than I imagined
by: Byron

I had surgery late October. Initially, pain was controlled via med's and coming off of being numb. But once overdrive kicked in I was like oh, oh, oh 12 out of 10 pain range. The med's did nothing except help me sleep.

I had no clue it would come on so strong. I've gotten past the worse "I believe" but still am at a constent 4-5 out of 10 range of pain.

The problem I have is Physical therapy. I go in a 5 and leave there an 7-9 pain range. I'd like to recover quickly but Physical Therapy almost seems to set me back vice pick me up.

I'm talking this regiment is violently painful. Please tell me it'll get better and soon. My doctor says to have the therapists scale back but the therapists have one gear "full throttle".

Nov 10, 2009
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Response to Bryon
by: Donna

Bryon - RUN from that physical therapy place and run fast! Recovery from this surgery is slow and you have to listen to your body. You shouldn't not be in that range of pain when you leave the PT's office. Some discomfort is the norm, but it should just be discomfort not pain. If you push your shoulder to its limit it is going to fight back with pain and only set you back.

There are those PT people who are aggressive and some that don't do enough. You have to find someone in the middle and mort importantly someone who will listen to you and your body. Unless you live in a remote area I am sure there are other PT places around. Find someone who is use to working with the arm/shoulder - there are PT people who specialize and that may be better for you.

The pain will get better, but you have to listen to your body so you don't have a setback and end up taking more predisone then is necessary. I have found Aleve to be very helpful. Ask you doctor how much you can safely take because you can take more than what is recommend. Also, using a bag of frozen peas an ice pack really works well because it conforms to your shoulder. It was my best friend for months!!

Hope tomorrow brings a better day for you.
Donna

Nov 11, 2009
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Going for this operation tomorrow
by: Anonymous

Hi Everyone,
Just found your site trying to get some information as to whats going to happen tomorrow.
I am having subacromial decompression surgery, and biceps tenodosis tomorrow afternoon, not really looking forward to it, but hoping I will have less problems than i am doing at the moment.
I slipped on my stairs 2 years ago come February and it has took me all this time to get to where i am now, i have had the Physio, the cortisone injections and no relief, so I am pinning all my hopes on this working for me tomorrow.
Nice to read all of your postings.
Kathy

Nov 11, 2009
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Response to Bryon
by: Donna

Sorry if this is a duplicate - I sent a reply yesterday and now I don't see. ;-( Anyway...If you are going in to PT at a 5 range they should be doing light stretches, massage to loosen the tight muscles and ultra sound to reduce the inflatmation and that is it. You shouldn't leave there in that much pain. They are doing you a disservice.

You need to find a new PT person and/or a new PT place to go too. There are some PT people who are very aggressive with deep tissue release techniques...they are not for everyone. There are then those who have a very light touch and while they are good while you are hurting you really need to find someone in between. You need someone who is going to listen to you and your body and they should be able to tell you "No, you are babying your shoulder and you can do more or You are doing too much we need to back off for a week and then slowly reintroduce that exercise."

Of course everyone will heal at a different rate, but what you are describing in concerning. I was told when I did PT and ended up with that much pain that we were moving forward to fast and that I needed to listen to my body - this was by the surgeon. Even the PT person was concerned and went back to the doctor for additional input on changing the regimate that was originally established.

It has been 1 1/2 years now since I had both shoulders done. I am finally seeing the light at the end of the tunnel. Most days I don't even notice the pain anymore and am down to one Aleve a day. I had been taking 4 a day and prior to that 2400 mg of Motrin a day. So, it will get better but you have to know when to do more and when to back off. You will have to do this on and off for months.

Take care and I hope you pain resolves quicker then mine did.

Donna

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Nov 11, 2009
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Submitted by: Donna

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Comment
Sorry if this is a duplicate - I sent a reply yesterday and now I don't see. ;-( Anyway...If you are going in to PT at a 5 range they should be doing light stretches, massage to loosen the tight muscles and ultra sound to reduce the inflatmation and that is it. You shouldn't leave there in that much pain. They are doing you a disservice. You need to find a new PT person and/or a new PT place to go too. There are some PT people who are very aggressive with deep tissue release techniques...they are not for everyone. There are then those who have a very light touch and while they are good while you are hurting you really need to find someone in between. You need someone who is going to listen to you and your body and they should be able to tell you "No, you are babying your shoulder and you can do more or You are doing too much we need to back off for a week and then slowly reintroduce that exercise." Of course everyone will heal at a different rate, but what you are describing in concerning. I was told when I did PT and ended up with that much pain that we were moving forward to fast and that I needed to listen to my body - this was by the surgeon. Even the PT person was concerned and went back to the doctor for additional input on changing the regimate that was originally established. It has been 1 1/2 years now since I had both shoulders done. I am finally seeing the light at the end of the tunnel. Most days I don't even notice the pain anymore and am down to one Aleve a day. I had been taking 4 a day and prior to that 2400 mg of Motrin a day. So, it will get better but you have to know when to do more and when to back off. You will have to do this on and off for months. Take care and I hope you pain resolves quicker then mine did. Donna

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Nov 19, 2009
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I'm back
by: Byron

I meant to mention this was my left shoulder. My last visit with the Physical Therapist brought up the subject of possible (FSS) Frozen Shoulder Syndrome or tear somewhere else. I'm still going in "same PT" and they're trying stretch it out.

Not sure if I'm going to receive another MRI or X-ray to narrow down the complications I'm suffering from after S A D surgery. I know one thing for sure I'm hurting and feel as though I'm adding to my injury during PT sessions.

Pain is still at a 24 hour (5-6). They've changed my meds but they simply get me more sleep.

I'll continue to check your notes to assist myself in making better choices.