Is it bullshit: subacromial decompression

[SpicyMeatball]

I had an MRI that shows my chronic shoulder pain is “moderate to severe tendinosis of the distal supraspinatus and infraspinatus tendons.” I’ve done PT and it helped a bit but I think it’s time to consider surgery. In doing the research it sounds like there are recent studies suggesting that the decompression surgery is no more effective than the PT people get to recover from the surgery, but they still seem to perform it on a lot of people and the science doesn’t seem settled.

I know a lot of you have had various surgeries, hoping to get some anecdotal evidence from y’all about whether this would be a waste of time and money, or if it would fix these damn painful shoulders.

 

[Nolport]

they literally shave off the bottom side of the acromion to give your supraspinatus tendon more space to breathe. Your acromion could be shaped in a way that makes you more prone to this pain too, which would make you a good candidate for it

you want to rule out other causes/solutions of your pain first. have you tried peptides? has your PT made sure your shoulder mechanics are fully normalized? have you tried taking time off from lifting heavy?

try that shit first before you jump into surgery. Surgery should be last resort. Sometimes you will come out of surgery worse than you were before. Also surgery will cause you to need to take a large amount of time off from lifting, so consider that too

 

[SpicyMeatball]

they literally shave off the bottom side of the acromion to give your supraspinatus tendon more space to breathe. Your acromion could be shaped in a way that makes you more prone to this pain too, which would make you a good candidate for it

you want to rule out other causes/solutions of your pain first. have you tried peptides? has your PT made sure your shoulder mechanics are fully normalized? have you tried taking time off from lifting heavy?

try that shit first before you jump into surgery. Surgery should be last resort. Sometimes you will come out of surgery worse than you were before. Also surgery will cause you to need to take a large amount of time off from lifting, so consider that too

My shoulder has been somewhat fucked since I was a kid, but i just sort of lived with it. A few years ago it got super fucked with a snowboarding fall that shouldn't have been a big deal with healthy shoulders and never came back, hence the MRI. The MRI showed I have a Type II acromion shape. I have done PT combined with BPC157, TB4, and HGH. I took a lot of time off after the injury to try to let it heal. It has helped some, but i still can't reach to pick something up off a table without a ton of pain.

I don't love the idea of surgery, but this is a degenerative condition that is probably only getting worse, and I am not getting younger. Quality of life as I enter my mid 40s is no small thing. However I definitely don't want to get a surgery that doesn't do what it's supposed to do, or anything super high risk. If subacromial decompression doesn't seem to do anything it is bananas that they continue to perform it all over the place, so I am having trouble getting to the bottom of it.

 

[Nolport]

Sounds like you've really exhausted your options then. Maybe one more thing you could try is decreasing your systemic inflammation with shit like glutathione, super clean diet, decreased upper body lifting, and the peptides/HGH on top. But that you would probably need to try for a long time for it to even be effective, and even then it might not work

type 2 acromion seems more susceptible to impingement pain than type 1 but less susceptible than type 3, so maybe that makes you a good candidate

do you know if you have a positive hawkin's kennedy test or neers impingement test? Your PT probably has done it on you. If not, look it up and have someone do it to you. The movements those tests do cause impingement by the position of your bones, so if your tendons are indeed getting impinged and inflammed/painful, those tests would hurt. However if you don't get pain from that, then your tendonopathy is not coming from impingement and it would be a retarded decision to get surgery for it

Although anecdotal reports might be interesting to read, I think you should look up some studies. That would give you more widespread data. Just go on pubmed and google scholar, combine subacrominal decompression with other keywords like "outcomes", "sequelae", "recurrent pain", shit like that. Remember systematic reviews and meta analyses are king. Also more recent studies are generally better

Heres one study on 180 people that showed "Major improvements in pain/function were seen at mid- to long-term after isolated arthroscopic subacromial decompression" Long-term results after surgical treatment of subacromial pain syndrome with or without rotator cuff tear - PMC

Also make sure you trust your surgeon if you decide to go through with it. If he is literal scum of the earth, maybe he would fuck up your shoulder more so you would go back to him for more surgeries and thus give him more and more paychecks. And you may never know if he does it on purpose because its known sometimes people just come out worse after surgery

 

[Nolport]

Another thought. If your shoulder has been fucked up since childhood a subacrominal decompression might not do anything, or might only partially improve your pain.

If impingement is worsening your pain then the surgery will help, but if impingement is not the PRIMARY reason for your pain then your pain wont go away 100% from freeing up more room. I hope that makes sense

 

[SpicyMeatball]

Another thought. If your shoulder has been fucked up since childhood a subacrominal decompression might not do anything, or might only partially improve your pain.

If impingement is worsening your pain then the surgery will help, but if impingement is not the PRIMARY reason for your pain then your pain wont go away 100% from freeing up more room. I hope that makes sense

It does, this is all very helpful. I’m not good at the medical system and generally just push through everything (probably how I ended up in this position) in order to avoid dealing with doctors and insurance. I don’t know if the PT did the tests you mentioned but if he didn’t I will take those as a next step. Thank you for all the input, like I said super helpful and appreciated