Arthroscopic Subacromial Decompression
How Is Arthroscopic Subacromial Decompression Performed?
Arthroscopic subacromial decompression is a minimally invasive procedure performed to relieve pain caused by subacromial impingement. This condition occurs when the rotator cuff tendons are compressed under the acromion (the bony part of the shoulder blade). During surgery, small incisions are made to insert a camera (arthroscope) and surgical instruments. The inflamed bursa is removed, and the undersurface of the acromion is smoothed by shaving away bone spurs or irregularities. This increases the space for the rotator cuff tendons to move freely, reducing friction and pain during shoulder movement.
What Is the Recovery in the Immediate Postoperative Period?
Hospital stay: Most patients go home the same day as surgery.
Sling: You will wear a sling for comfort for the first 1–2 weeks, but it can be removed for gentle exercises and daily activities.
Range of motion: Shoulder movement is encouraged.
Ice: Used frequently to control pain and swelling. You should ice for 20 minutes, 3–4 times per day immediately after surgery. An ice/compression machine can be hired from a third party.
Sleep: You may find it more comfortable to sleep in a reclined or semi-upright position with the sling on for the first few nights.
How Is the Wound Managed?
Bulky dressings will be removed 1–2 days after surgery.
A waterproof underlay dressing should be left on for 2 weeks.
Incisions typically heal within 2 weeks.
Showers are permitted while wounds are covered with waterproof dressings during the first 2 weeks.
Do not submerge incisions in water (baths, pools, or ocean) for 4 weeks.
A wound check with your GP, allied health provider, or our clinic is recommended at 2 weeks.
Absorbable sutures are usually used and do not require removal, though small remnants may surface naturally during healing.
How Do I Manage My Pain After an Arthroscopic Subacromial Decompression Procedure?
Your anaesthetist may use a regional nerve block to help control pain immediately after surgery.
Local anaesthetic will also be injected into the shoulder during the procedure.
Use ice regularly (20 minutes, 3–4 times per day). An ice machine may be hired from a third party.
Take prescribed pain medication as directed. Opioids may be used short-term but have known side effects (nausea, constipation, dependence). Non-opioid medications such as paracetamol or anti-inflammatories are preferred when tolerated.
Keep the arm supported in the sling for comfort and avoid repetitive overhead activity for the first few weeks.
What Issues Should I Call the Clinic Regarding?
You should contact your surgeon or clinic immediately if you notice:
Increasing redness, swelling, or foul-smelling drainage from the wound.
Persistent or worsening pain not controlled by medication.
Fever, chills, or night sweats.
Numbness, tingling, or weakness that does not improve after the nerve block wears off.
Any sudden injury or fall resulting in pain or loss of movement.
Prompt review allows early management of potential complications.
When Can I Return to Normal Activities After Arthroscopic Subacromial Decompression?
Recovery varies depending on the degree of inflammation and any associated procedures performed. As a general guide:
Light daily activities: Immediately, using your non-operated arm.
Desk or computer work: 1–2 weeks, if comfortable.
Shoulder movement: Begin gentle exercises within the first week.
Strengthening: Starts around 4–6 weeks, progressing as comfort improves.
Sport or overhead activity: Typically 8–12 weeks, depending on recovery and physiotherapy progress.
When Can I Drive?
You can usually drive once you can safely control the steering wheel and perform emergency manoeuvres comfortably. This is typically around 2–4 weeks after surgery. You must not drive while taking strong pain medication (e.g., opioids).
When Can I Return to Work?
Return to work depends on your occupation:
Office or sedentary work: 1–2 weeks, once you can safely commute and perform desk duties.
Light manual work: 4–6 weeks.
Heavy manual labour or overhead work: 8–12 weeks, depending on recovery and surgeon clearance.
Should I See a Physiotherapist?
Physiotherapy is recommended for optimal recovery after arthroscopic subacromial decompression. Your physiotherapist will:
Guide you through exercises to restore range of motion, posture, and shoulder mechanics.
Progressively strengthen the rotator cuff and scapular stabilisers.
Focus on proper movement patterns to reduce the risk of recurrence.
Most patients continue physiotherapy for 6–12 weeks for best results.
What Are the Complications After an Arthroscopic Subacromial Decompression Procedure?
While uncommon, potential complications include:
Persistent shoulder pain or stiffness.
Infection or wound healing issues.
Bleeding or swelling within the joint.
Nerve injury, irritation, or numbness around the shoulder.
Incomplete pain relief if rotator cuff or biceps pathology is also present.
Recurrent impingement symptoms.
Rarely, fracture of the acromion or clavicle with excessive resection.
Complications related to the anaesthetic block (temporary nerve effects, shortness of breath, or rarely pneumothorax).
