Rationale: A large number of patients with shoulder pain undergo MRI, often revealing supraspinatus tendinosis. However, subacromial pain is a clinical diagnosis, and MRI is usually not necessary. The effectiveness of acromion resection remains highly uncertain. Around 80% of patients with subacromial pain experience significant improvement with proper physiotherapy. There is no strong evidence that surgical intervention is more effective than conservative treatment. Additionally, surgery carries a risk of complications.
References:
• Acta Orthopaedica Volume 85, 2014 - Issue 3: Guidelines for diagnosis and treatment of subacromial pain syndrome. A multidisiplinary review of the Dutch Orthopaedic Association. Diercks et al.
• Acta Orthop. 2017 Dec;88(6):600-605. doi: 10.1080/17453674.2017.1364069. Epub 2017 Aug 16.: Specific exercises for subacromial pain. Bjørnsson Hallgren HC et al.
• Cochrane Database Syst Rev. 2016 Jun 10;(6):CD012224. doi: 10.1002/14651858.CD012224.: Manual therapy and exercise for rotator cuff disease. Page MJ, et al.
• Lancet. 2018 Jan 27;391(10118):329-338. doi: 10.1016/S0140-6736(17)32457-1. Epub 2017 Nov 20. Arthroscopic subacromial decompression for subacromial shoulder pain (CSAW): a multicentre, pragmatic, parallel group, placebo-controlled, three-group, randomised surgical trial. Beard DJ, et al