Kaitlyn D’Onofrio

DocwireNews

<p>A panel of experts recently released a clinical practice guideline strongly recommending against operative treatment for patients with subacromial pain syndrome (SAPS), also labelled as rotator cuff disease.<p>&ldquo;SAPS is the common diagnosis for shoulder pain with several first line treatment options, including analgesia, exercises, and injections,&rdquo; the panel wrote in <em>The BMJ</em>. &ldquo;Surgeons frequently perform arthroscopic subacromial decompression for prolonged symptoms, with guidelines providing conflicting recommendations.&rdquo;</p><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">An international panel of experts strongly recommend against surgery for the most common shoulder pain in <a href="https://twitter.com/bmj_latest?ref_src=twsrc%5Etfw">@bmj_latest</a> today <a href="https://t.co/HnSszen8HS">https://t.co/HnSszen8HS</a>   <a href="https://twitter.com/hashtag/BMJInfographic?src=hash&amp;ref_src=twsrc%5Etfw">#BMJInfographic</a> <a href="https://t.co/0LaWGuY3AE">pic.twitter.com/0LaWGuY3AE</a></p>
<p>&mdash; BMJ (@bmj_company) <a href="https://twitter.com/bmj_company/status/1093419184816640000?ref_src=twsrc%5Etfw">February 7, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p><h2><strong>Shoulder Surgery Does Not Improve Pain, Function Outcomes</strong></h2><p>Per their findings, surgery was not associated with improvements in pain, function, or quality of life when compared to patients who received placebo surgery or sought alternative treatment options. Operative patients may also have increased risk for frozen shoulder, they noted.</p><p>The final analysis included data from seven randomized, controlled trials including a total of 1,014 patients (mean age at baseline, 49.1 years; mean symptom duration prior to enrollment, 2.1 years).</p><p>The researchers analyzed and compared the benefits and harms associated with subacromial decompression surgery versus nonoperative management. There were no significant between-group differences for the operative group and nonoperative management patients in mean outcomes for:</p><ul>
<li>Visual analog scale pain score (2.6 vs. 2.9)</li>
<li>Constant score scale, function (72 vs. 69)</li>
<li>EQ-5D scale, quality of life (0.70 vs. 0.73)</li>
<li>Events per 1,000 people (global perceived effect, 699 vs. 635; at work, 859 vs. 818)</li>
</ul><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">New recommendation article from Vandvik et. al. In Feb 19 BMJ on subacromial decompression surgery and it&rsquo;s recommendation against them and to look strongly towards non-surgical measures &#128077; <a href="https://t.co/BlscCf5VgH">https://t.co/BlscCf5VgH</a>   <a href="https://twitter.com/hashtag/shoulder?src=hash&amp;ref_src=twsrc%5Etfw">#shoulder</a> <a href="https://twitter.com/hashtag/RCRSP?src=hash&amp;ref_src=twsrc%5Etfw">#RCRSP</a> <a href="https://twitter.com/hashtag/mskphysio?src=hash&amp;ref_src=twsrc%5Etfw">#mskphysio</a></p>
<p>&mdash; J&#128522;nny Trumble &#127987;&#65039;&zwj;&#127752; (@jonny_trumble) <a href="https://twitter.com/jonny_trumble/status/1095365836041306115?ref_src=twsrc%5Etfw">February 12, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p><p>In terms of events per 1,000 people, there were six serious harms in the surgical group, but none in the nonoperative management group.</p><h2><strong>Shoulder Pain Patients &lsquo;Do Need Support and Compassion&rsquo;&mdash;But Maybe Not Surgery</strong></h2><p>&ldquo;Shoulder pain can be excruciating and patients do need support and compassion,&rdquo; Dr. Rudolf Poolman, the study&rsquo;s senior author and an orthopedic surgeon scientist in the department of orthopedic surgery at OLVG in Amsterdam, told <a href="https://www.reuters.com/article/us-health-shoulder-surgery/expert-panel-advises-against-surgery-for-shoulder-pain-idUSKCN1PW2NL">Reuters</a>. &ldquo;The evidence shows that surgery works as well as a placebo surgery or physiotherapy. Surgeons should realize this and reassure the patient that the pain will subside eventually and that surgery has potential side effects that can make matters worse.&rdquo;</p><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">Subacromial decompression surgery for adults with shoulder pain &ndash; strong evidence against surgery &#8294;<a href="https://twitter.com/bmj_latest?ref_src=twsrc%5Etfw">@bmj_latest</a>&#8297; &#8294;<a href="https://twitter.com/KlokeValg?ref_src=twsrc%5Etfw">@KlokeValg</a>&#8297;  <a href="https://t.co/CJZAhnU4oq">https://t.co/CJZAhnU4oq</a></p>
<p>&mdash; Jan Frich (@DrFrich) <a href="https://twitter.com/DrFrich/status/1095203460449009664?ref_src=twsrc%5Etfw">February 12, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p><p>Evidence does not exist to prove that surgery benefits patients with tendinopathy, Poolman added to Reuters: &ldquo;Shoulder pain is multifactorial and also factors not related to the shoulder &ndash; such as psychological and social factors &ndash; are very important to take into account.&rdquo;</p><p>The researchers wrote in their paper: &ldquo;Clinicians should not offer patients subacromial decompression surgery unprompted, and clinicians, public healthcare providers, and others should make efforts to educate the public regarding the ineffectiveness of surgery. Although we did not take costs and resources into account beyond direct costs to patients (such as out-of-pocket costs), surgery cannot be cost effective given the lack of important benefit, potential for harm, and associated costs.&rdquo;</p><blockquote class="twitter-tweet" data-width="500" data-dnt="true">
<p lang="en" dir="ltr">.<a href="https://twitter.com/bmj_latest?ref_src=twsrc%5Etfw">@bmj_latest</a> published a clinical practice guideline for subacromial decompression surgery for adults with shoulder pain. This is a must read for all clinicians! <br>Here is the link to full text, <a href="https://t.co/h9oOuRh2Of">https://t.co/h9oOuRh2Of</a> <a href="https://t.co/utmMII99yR">pic.twitter.com/utmMII99yR</a></p>
<p>&mdash; Saurab Sharma, PhD (@link_physio) <a href="https://twitter.com/link_physio/status/1095168009209970688?ref_src=twsrc%5Etfw">February 12, 2019</a></p>
</blockquote><p><script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script></p><p><a href="https://proddocwire.wpengine.com/abstracts/shoulder-arthroplasty-nonelderly-patients/">Comparison of 90-Day Perioperative Outcomes in Shoulder Arthroplasty Between the Elderly and Nonelderly Patients</a></p><p><a href="https://proddocwire.wpengine.com/orthopedic-surgery/genetic-variants-involved-in-extracellular-matrix-homeostasis-play-a-role-in-the-susceptibility-to-frozen-shoulder-a-case-control-study/">Genetic variants involved in extracellular matrix homeostasis play a role in the susceptibility to frozen shoulder: a case&ndash;control study</a></p><p><a href="https://proddocwire.wpengine.com/orthopedic-surgery/reverse-shoulder-arthroplasty-in-acute-fractures-of-the-proximal-humerus-does-tuberosity-healing-improve-clinical-outcomes/">Reverse Shoulder Arthroplasty in Acute Fractures of the Proximal Humerus: Does Tuberosity Healing Improve Clinical Outcomes?</a></p><p><a href="https://proddocwire.wpengine.com/orthopedic-surgery/model%E2%80%90based-rsa-is-suitable-for-clinical-trials-on-the-glenoid-component-of-reverse-total-shoulder-arthroplasty/">Model&#8208;based RSA is suitable for clinical trials on the glenoid component of reverse total shoulder arthroplasty</a></p><p>Source: <a href="https://www.bmj.com/content/364/bmj.l294">The BMJ</a></p></p>


Sara Nunnery, MD, MSCI

Reclassifying HER2: What Oncologists Need to Know About HER2-Low and -Ultralow Breast Cancer

HER2 Breast Cancer

Jeffrey Perl, MD

Joel M. Topf, MD, FACP

Thoughts From the 2025 Lazarus Award Winner

NKF Spring Clinical Meetings 2025

Brandon Twyford

DESTINY-Breast09 Demonstrates First-Line Superiority of Enhertu Plus Pertuzumab in HER2-Positive Metastatic Breast Cancer

Latest News

Experts Advise Against Shoulder Surgery for Rotator Cuff Disease

Orthopedics

A panel of experts recently released a clinical practice guideline strongly recommending against operative treatment for patients with subacromial pain syndrome (SAPS), also ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HR Breast Cancer

Triple-Negative Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe