No better than placebo therapy: shoulder surgery is often unnecessary

No better than placebo therapy: shoulder surgery is often unnecessary

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New study: Many shoulder blade operations are superfluous

Patients with shoulder pain often end up on the operating table. But a new study now shows that many of the shoulder surgeries are superfluous. Conservative treatments such as physiotherapy could help more sufferers.

Too many operations in Germany

In recent years it has been repeatedly criticized that too much and too quickly is operated on in German clinics. In case of doubt, patients should therefore ask about the necessity before an operation and, if necessary, obtain a second medical opinion. This obviously makes sense especially when it comes to shoulder operations. According to a recent study, such interventions are often superfluous.

Patients with shoulder pain often end up on the operating table

Shoulder pain radiating from the neck, pain when lifting the arm over the shoulder, pain on the shoulder blade: According to health experts, the frequency of chronic shoulder pain has increased significantly in recent years.

Such complaints can severely restrict freedom of movement and make everyday life difficult.

Physiotherapy can relieve pain in many shoulder diseases. However, some patients also end up on the operating table.

If the space between the shoulder joint and the overlying bone process on the shoulder blade is too small, an attempt is sometimes made to alleviate the symptoms by means of a minimally invasive procedure.

With this shoulder blade extension, some bone material or tissue is removed in order to create space and relieve the pressure on tendons, for example.

British scientists are now reporting in The Lancet magazine that many interventions could be dispensed with.

Improvement attributed to placebo effect

For their study, the British scientists led by David Beard from the University of Oxford investigated whether the operation resulted in more pain relief than a sham procedure.

To do this, they divided the more than 300 study participants into three groups: Around 100 test subjects each underwent surgery or a sham intervention without removing bone material. The rest of the patients served as an additional control group.

The results: According to the scientists, there was no measurable difference between the two groups of operations. They did slightly better than the untreated patients, but this difference was not clinically relevant.

The researchers assume that the improvement is due to the placebo effect.

Operation with no clinical benefit

"The results of our study indicate that surgery does not offer a clinically meaningful advantage over no treatment, and that shoulder expansion is no better than a placebo procedure," study author Andrew Carr said in a statement.

His colleague David Beard, who is also researching at Oxford University, said that in view of the study results, “painkillers, physiotherapy and steroid injections” should be used.

Natalie Carter of Arthritis Research UK also said the study suggests that "other treatments such as physiotherapy can be as effective as shoulder surgery and should be considered in patients who are considering surgery."

"Shoulder pain can often be short-lived, but if you have shoulder pain that persists or worsens for more than two weeks, talk to your doctor or a physiotherapist," said the expert.

The British scientists' study was also well received in Germany. For example, surgeon Felix Zeifang from Heidelberg University described the examination as "a very well-prepared study", according to a message from the dpa news agency.

According to the doctor, the shoulder blade surgery is still used too often, despite previous scientific studies, while conservative treatments such as physiotherapy would help at least two out of three patients.

"Surgery can only be discussed after months of unsuccessful conservative therapy." (Ad)

Author and source information

Video: Shoulder Impingement Update: Why you should not use the term Shoulder Impingement anymore. (August 2022).