Subacromial Decompression

Subacromial decompression is performed under a general anaesthetic as a day case surgery, so you’ll be asleep throughout the surgery and will be able to go home after.

Here’s what to expect on the day:

What to expect on the day

Admission – You’ll be admitted by a nurse to your private room. This will include taking a short medical history, checking your medications, and recording pre-operative observations such as blood pressure, pulse, temperature and oxygen levels.

Discussion with your surgical team – Your surgeon and anaesthetist will visit you in your room to talk through the procedure, answer any questions and gain your consent.

Monitoring and preparation in theatre – When you’re taken to theatre, monitoring will be attached to check your heart rate, blood pressure, and oxygen levels throughout the procedure. A cannula (small plastic tube) will be placed into a vein, usually on the back of your hand or in your arm.

Anaesthetic – You’ll be given a general anaesthetic, so you are fully asleep for the operation.

Nerve block (if used) – Before your operation, your anaesthetist will discuss with you whether a nerve block is appropriate. If agreed, the block is given after you are asleep, under ultrasound guidance. It involves injecting local anaesthetic near the major nerves supplying the shoulder and arm to provide extra pain relief after surgery. If you have a block, your shoulder and arm may feel numb, weak or heavy for several hours after the operation. You won’t be able to move the arm normally until sensation and strength return. The effects usually wear off within the first day.

Surgery – Once the anaesthetic (and block, if used) is in place, the skin around your shoulder is cleaned with antiseptic and small incisions are made to insert the arthroscope (camera) and surgical instruments. Your surgeon will carry out any necessary treatment, such as removing inflamed tissue or shaving a small amount of bone to create more space for the tendons to glide freely. At the end, the instruments are removed and the incisions are closed and dressed. You may be fitted with a sling to support your shoulder immediately afterwards.

Recovery – After surgery, you’ll return to your room, rather than a separate recovery area. Staff will monitor you as you wake up, including regular checks of your blood pressure, oxygen levels and comfort. If you had a block, your shoulder and arm may still feel numb or heavy for a time. Before you go home, the team will give you advice on pain relief, wound care and how to use your sling safely.

Subacromial decompression is a safe procedure, and complications are not common.

After-effects are similar to any surgery under general anaesthetic, such as pain, bruising, swelling and stiffness as you heal, and feeling tired or sick.

Possible risks include:

• lack of symptom relief, need for further surgery, new bone formation, or problems with healing (more common – 1 in 10 to 1 in 100 people)

• infection, bleeding, nerve injury, or worsening of pain (rare)

Your consultant will answer any questions and make a plan with you ahead of your procedure. Tell them if there is any chance you could be pregnant (women of childbearing age will be offered a test).

Other things to consider:

• if you have time before surgery, you may be encouraged to stop smoking and lose weight, as this can reduce the risk of blood clots and speed recovery

• plan ahead for meals and household support in the first few days after surgery

• you’ll have a medication review and may need to stop certain medicines, such as blood thinners

• alcohol thins the blood, so you may be advised to reduce intake and avoid drinking in the 24 hours before surgery

On the day you will need to:

• bring loose, comfortable clothing so you can easily get dressed after the surgery

• bathe or shower before you arrive to make sure the area is clean

• leave jewellery and piercings at home if possible, as these usually need to be removed before surgery

• keep make-up to a minimum

• if you wear nail varnish, please leave at least one nail free of varnish on each hand, as this helps with monitoring during your operation

• fast as advised – don’t eat solid food for 6 hours before your operation, and only drink clear fluids up to 2 hours before, unless told otherwise by your consultant

• take any agreed regular morning medications with a small sip of water

You will be monitored after your surgery to make sure you are recovering from the anaesthetic and your health checks, such as blood pressure, oxygen levels, and pain management, are all as expected.

You will be given information about:

• keeping your wounds clean and taking showers, not baths, until they heal

• managing your post-operative pain with painkillers, ice, and particular sleeping positions

• exercising as directed by your physiotherapist to keep your blood flowing and start mobilising your hip

You’ll likely be asked to eat and drink, and also pass urine, before you’re discharged.

Key things to note:

• you’ll need someone to take you home – you cannot drive

• pain relief is key – use medication and ice packs as directed

• aim to manage without the sling in around 2 to 5 days

• sleeping might be more comfortable lying on your back, possibly with a pillow under your upper arm/elbow

• remember to shower, not bathe and avoid using soap or rubbing the area as this can dislodge the dressings

• adapt your getting dressed and sitting down routines – you need to avoid aggravating your recovering shoulder

• your physiotherapy exercises are crucial to recovery – make sure you do the recommended work from day 1 after surgery, and then you’ll progress to more exercises after a week or 2

As this is a significant surgery, and everyone is different, your consultant will always book a first follow-up appointment at around 6 weeks after your surgery. This is to:

• check how your recovery is going, including physiotherapy, comfortable sleeping and mobility

• answer any questions you have about ongoing pain management, such as reducing or changing medications

• talk through any concerns you may have about getting back to work or exercise

• discuss access to the multi-disciplinary teams at Welbeck, who offer additional support such as physiotherapy

Please contact our Surgery Centre for pricing information.

At Welbeck, our orthopaedic surgeons are experts in their field and are dedicated to providing world-class care to every patient.

With access to colleagues across other specialties, our consultants are also able to refer within the Welbeck ecosystem if required to ensure you receive the treatment you need as quickly as possible, all under one roof.  

All appointments, testing, treatment, and follow-up appointments take place within our state-of-the-art facilities, enabling us to deliver accurate diagnostics and advanced treatments.

To book a subacromial decompression, you must be referred by either your GP or a specialist dealing with your particular type of pain, following a consultation with them. Self-referrals are not accepted for this treatment.

If you would like to schedule a consultation with a specialist, please get in touch to make an appointment. Your health is important to us, so we strive to offer same-day appointments whenever possible.

Our consultants are recognised by the major health insurance companies. If you have private health insurance, your treatment at Welbeck can begin once you have obtained authorisation. We also provide care to self-paying patients. Learn more about the different payment options at Welbeck.