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Shoulder pain treatment

Shoulder surgery can significantly improve your shoulder pain and function.

We offer private shoulder surgery for people battling pain or restricted movement in their shoulder. Shoulder problems can occur for many reasons, including an injured tendon or muscle, arthritis (this can damage the joints and bones that form your shoulder) and referred pain (shoulder pain caused by problems in another area of your body, such as your neck or back). These are just some of the problems that can cause shoulder pain.  

Understanding your shoulder joint

Your shoulder joint is made up of your humeral head, a ball at the top of your humerus (arm bone) and a glenoid, which is a shallow socket in your scapula (shoulder blade). The ends of your humeral head (ball) and glenoid (socket) are wrapped in smooth tissue, known as articular cartilage. This cushions the bones that form your shoulder, helping you to move your bones painlessly and with ease. A group of muscles known as your rotator cuff also helps facilitate the movement of your shoulder. 

Your rotator cuff consists of four muscles that help keep your shoulder in place and manage its movement. The four tendons of these muscles fuse together to form a single large tendon referred to as your rotator cuff tendon. This tendon attaches to your humeral head (the ball at the top of your arm bone) and passes through a space underneath your acromion (a bony area at the top of your shoulder blade) when you lift your arm. This space is referred to as your subacromial space. 

Your rotator cuff tendon can become damaged from inflammation in your tendon, or through a tear. A tear is known as a rotator cuff tear. The articular cartilage in your shoulder joint bones can also become damaged due to arthritis, or a shoulder injury. You might be advised to have shoulder surgery to repair any damage to these structures within your joint.

The common reasons why you might need shoulder surgery include:  

Osteoarthritis: Osteoarthritis impacts an estimated nine million people across the UK. It occurs when the cartilage that covers the ends of your joint begins to break down. As a result, the bones that form your joint begin to rub together causing pain, inflammation and stiffness.  

Rheumatoid arthritis: This form of arthritis affects 1% of the UK population. It is caused by your immune system attacking the cells that line your joints, which leads to swelling, pain and stiffness in your shoulder.  

Frozen shoulder:
A frozen shoulder is caused by an abnormality in the lining of your joint, which can lead to shoulder pain and stiffness.  

Rotator cuff tear: Your rotator cuff tendon can tear following an injury such as a shoulder dislocation, an overuse of your shoulder from playing sport, or as part of wear and tear of the tendon due to ageing. Rotator cuff repair surgery can help repair the tear in your rotator cuff.  

Shoulder impingement: If your rotator cuff tendon rubs against your acromion (the bony part of your shoulder blade) when you raise your arm, you are suffering from shoulder impingement. A shoulder impingement can occur due to the irritation or inflammation in the bursa (fluid-filled sac) located between your rotator cuff tendon and acromion, or following a tear in your rotator cuff tendon (rotator cuff tear). 

Shoulder instability:
Shoulder instability can be caused by dislocation, an injury where your humeral head (the ball at the top of your arm bone) is completely removed from its socket, or subluxation (when your joint is only partially out of place after an injury).  

When is surgery for shoulder problems recommended?


If you are suffering from shoulder problems, your GP or a specialist might recommend initial treatment such as pain relief medication and steriod injections to relieve pain and inflammation in your joint. You could also be advised to have physiotherapy to improve your symptoms. People of all ages can benefit from physiotherapy, which can involve exercises to strengthen your shoulder, relax your muscles and joints and relieve stiffness and pain.  

If physiotherapy, steroid injections, and pain relief medication have not helped alleviate your symptoms, you might be advised to have surgery.

Common symptoms that can indicate the need for shoulder surgery include: 

Sudden, severe shoulder pain: If you cannot move your arm due to severe shoulder pain, you might have suffered a broken collarbone (fracture) or a dislocated shoulder. Your Surgeon can realign any broken bones or perform shoulder dislocation surgery if you have suffered a dislocation. A rotator cuff tear can also make it difficult to raise your arm. Rotator cuff repair might be recommended to attach the tendon back to your humerus (arm bone).  

Shoulder pain that worsens when using your arm or shoulder: This can be a symptom of a shoulder impingement or bursitis (which happens when a small sac around your joints becomes inflamed, causing swelling and pain). If you have severe or reoccurring bursitis, your Orthopaedic Consultant can perform surgery (shoulder bursitis surgery) to remove or drain your bursa. If this symptom is caused by a shoulder impingement, arthroscopic shoulder surgery can be performed to relieve your symptoms.  

Persistent pain or stiffness: Chronic pain or stiffness can be caused by osteoarthritis, rheumatoid arthritis, or a frozen shoulder. Comprehensive arthroscopic management can be carried out to alleviate pain and shoulder stiffness induced by arthritis. If you have severe arthritis, your Consultant might recommend shoulder replacement surgery, which involves replacing the damaged surfaces of your joint with artificial parts. Arthroscopic shoulder surgery, such as shoulder manipulation, can treat persistent pain and stiffness induced by frozen shoulder.  

Numbness or weakness in your shoulder: This can be caused by shoulder instability due to a dislocation or hypermobility (increased flexibility in the joints).  

Is shoulder surgery a major surgery?


It is important to note that shoulder surgery is a major surgery. If you are advised to have surgery for your shoulder problems, your Orthopaedic Surgeon will explain what this will involve, including how to prepare for surgery and its many benefits. Our specialists will to support you throughout each step of your healthcare journey (even after your surgery), to ensure your complete recovery.

If you are advised to have shoulder surgery, your Orthopaedic Surgeon might advise making some lifestyle changes to prepare for surgery. This could include:  

Quitting smoking: Smoking can put you at risk of experiencing post-surgery complications, such as wound infections and deep vein thrombosis or DVT (a blood clot in your vein). If you smoke, your Consultant will provide you with information and support to help you quit smoking ahead of your surgery.  

Stopping hormonal medication (for women): If you are on the oral contraceptive pill, you will need to stop taking the pill at least four weeks prior to your operation due the increased risk of deep vein thrombosis (DVT). Medication such as hormone replacement therapy might also need to be stopped, especially if you are at higher risk of experiencing of DVT. 

Attending a preoperative assessment

Prior to your operation, you may need to undergo a pre-operative assessment, which is a general health check to ensure you are fit for surgery. You will be advised to bring your current medication to this assessment. A Nurse will measure your blood pressure and weight during this assessment to evaluate your health. A blood test or an echocardiogram (a scan that examines your heart and surrounding blood vessels) might also be performed at this assessment.  

Things to remember before your surgery

  • Bring your current medication to your assessment and surgery
  • Avoid wearing any jewellery or nail varnish, as this will need to be removed before your operation
  • If you are administered general anaesthetic, you will not be able to drive or operate machinery for at least 24 hours after your surgery. It is recommended that you do not drive yourself to our hospital. Instead, you can use public transport or ask someone to drive you

Prior to your shoulder arthroscopy, you will be administered general anaesthetic.  Alternatively, local anaesthetic might be administered to numb your shoulder and arm, preventing you from experiencing any pain during your operation.  

An arthroscope (a thin tube with a camera attached to it) is then passed through a small incision on the back of your shoulder. The camera is connected to a video monitor, which allows your Surgeon to examine the inside your shoulder joint. Your Surgeon will create one to three further incisions in your skin to insert specialist surgical instruments, which will be used to remove or repair any damage to the structures in your shoulder joint. The incisions will be closed with stitches and a bandage will be placed over them. 

An arthroscopic surgery can be performed for many shoulder procedures, including:  

Rotator cuff repair


A rotator cuff repair is carried out through an arthroscopy to reattach your torn rotator cuff tendon to your humerus (arm bone). In addition to general anaesthetic, you could be administered local anaesthetic to alleviate pain following your rotator cuff surgery. 90% of patients who undergo a rotator cuff repair experience improvement in their pain and an increased ability to move their shoulder.  

Arthroscopic subacromial decompression (shoulder impingement surgery


When you raise your arm, your rotator cuff tendon passes through an arch known as your coracoacromial arch. If your rotator cuff tendon rubs against the acromion (a bone that forms this arch), it can cause a shoulder impingement, which can lead to pain, inflammation, or a tear in your rotator cuff tendon. However, subacromial decompression surgery uses an arthroscopy technique to release the ligament in this arch and shave the surface underneath your acromion, providing your rotator cuff tendon with more room to move and reducing restrictive pain as a result.  

Shoulder manipulation under anaesthetic (MUA)


Frozen shoulder occurs due a problem in your capsule (lining) covering your shoulder joint, which can cause your capsule to become inflamed and stiff. Shoulder manipulation through an arthroscopy could alleviate your symptoms. A saline solution is first inserted into your shoulder joint to stretch your capsule. Your Surgeon will then surgically release your tight capsule and manipulate your shoulder joint to restore movement in your joint.  

Comprehensive arthroscopic management


Comprehensive arthroscopic management uses arthroscopic surgery to treat parts of your shoulder that are affected by arthritis. The first stage of this treatment involves removing any damaged labrum tissue (a rim of cartilage around your shoulder joint’s socket). Your Surgeon will then smooth the bone within your joint and release any scarred tissue near your humerus (arm bone). The final stage will involve relieving pressure off the auxiliary nerve (the nerve that is associated with arthritic shoulder pain).  

Shoulder stabilisation surgery


After a dislocation or subluxation, you could have torn or stretched ligaments in your shoulder and the rim of cartilage around your joint’s socket might be damaged. Shoulder stabilisation surgery involves repairing the damaged cartilage and tightening any stretched ligaments.  

When is open surgery recommended?


Procedures such as shoulder replacement surgery are performed through an open surgery, where a single incision (around 7cm) is made on the front of your shoulder to carry out your surgery. Open surgery is sometimes used to perform a shoulder stabilisation surgery. 

How long does a shoulder arthroscopy take?


Although a shoulder arthroscopy can take around 60 to 90 minutes to perform, the duration of your surgery will depend on your diagnosis and the type of shoulder surgery that is advised. 

Following your surgery, you will be taken to a recovery room and your arm will be placed into a sling. Your Consultant will explain when you can stop wearing the sling and how to look after your wounds. If an arthroscopy was used to perform your shoulder surgery, you should be able to return home the same day. Open procedures, such as shoulder replacement, could require an overnight hospital stay. You might experience some pain following your surgery. In this instance, pain relief medication will be administered to reduce your pain. 

Before you go home, you will meet with a Physiotherapist who will share a tailored exercise plan to support your recovery at home. These exercises could include shoulder elevation exercises. During these, you might be required to lift both arms above your head to improve their motion. Your Physiotherapist might ask you to repeat these exercises at least two to three times a day while recovering at home.  

During your recovery at home, you will be advised to remove your sling when showering, getting dressed or performing your shoulder exercises. If you are finding it difficult to sleep with a sling, you might prefer to sleep on your back. Your Physiotherapist will advise that you avoid driving until you can comfortably move your shoulder and you no longer require a sling. 

Your return to work will depend on your surgery and the type of work that you do.

As with any surgery, there are potential risks that are associated with having shoulder surgery. These include:  

Infection: If you do experience an infection, your Consultant can give you antibiotics to treat this infection; 

Blood clots: You will be asked to move around as much as possible and might be given compression stocking to minimise your risk of blood clots; 

Swelling and bruising around your wound:
You could experience some bruising or swelling but this should resolve with time, and 

Scarring: There might be small scars at the site of your incision(s). However, these should become less noticeable over time.

The cost of having shoulder surgery at our hospitals will vary depending on your chosen hospital, diagnosis, and the procedure that you need. 

If you are advised to have private shoulder surgery, this can cost from around to £11, 895. 

It is important to note the above is only a guide price. The final cost of your treatment will be confirmed in writing and will include the cost of all your anaesthesia, surgery and aftercare.  

At our hospitals, we offer many flexible payment options to help cover the cost of your treatment. For further information, please visit our payment options page.

If you are struggling with shoulder problems, we provide fast access to effective, tailored treatment. Our specialists will support you throughout your healthcare journey, from your initial appointment, right through to your return to your everyday life.  

If you would like to learn more, book your appointment online today or call a member of our team directly on 0141 300 5009.

Specialists offering Shoulder pain treatment

Mr Shoaib Arshad

Consultant Hand & Wrist Surgeon

MBChB, FRCS (Tr&Orth), MSc (Hand Surgery)

BMI The Highfield Hospital 1 more BMI The Alexandra Hospital

View profile Book online

Mr Samuel Orakwe

Consultant Orthopaedic & Trauma Surgeon

MBBS, FRCS (Ed), FRCS (Orth)

BMI The Blackheath Hospital 1 more BMI The Sloane Hospital

View profile Book online

Mr Alan Johnstone

Consultant Orthopaedic Surgeon

MBChB, FRCSE, FRCS Glas, FRCSE Orth

BMI Albyn Hospital

View profile Book online

Mr Dimitri Yanni

Consultant Orthopaedic & Hand Surgeon

MB,BS London – Guy’s, FRCS (England), FRCS (Edinburgh), FRCS Orthopaedic

BMI The Blackheath Hospital 2 more BMI Chelsfield Park Hospital BMI The Sloane Hospital

View profile Book online

Mr Magdi El-Guindi

Consultant Orthopaedic Surgeon

MBBch FRCS

BMI The Chiltern Hospital 1 more BMI The Shelburne Hospital

View profile Book online

Mr Srinivas Gadikoppula

Consultant Orthopaedic Surgeon

MBBS, MS (Ortho), FRCS, FRCS, (Tr & Ortho)

BMI The Cavell Hospital 1 more BMI The Kings Oak Hospital

View profile Book online

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