No better than placebo therapy Shoulder surgery is often unnecessary

New study: Many shoulder blade operations are redundant

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 in German hospitals too much and too fast surgery. Patients should therefore in case of doubt ask before surgery for the necessity and, if necessary, obtain a second medical opinion. This is obviously useful, especially when it comes to surgery on the shoulder. After all, such interventions are often superfluous, according to a recent study.

Many patients with shoulder pain are operated on. But according to a new study, many of these surgeries are redundant. Often, physiotherapy or other treatments can help. (Image: SENTELLO / fotolia.com)

Patients with shoulder pain often end up on the operating table

From the neck radiating shoulder pain, pain when lifting the arm over the shoulder, pain on the scapula: The incidence of chronic shoulder pain has increased according to health experts in recent years significantly.

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

In many diseases of the shoulder, physiotherapy can relieve the pain. Some patients also end up on the operating table.

If the space between the shoulder joint and the overlying bone appendage on the scapula is too narrow, attempts are sometimes made to alleviate the discomfort through a minimally invasive procedure.

In this shoulder blade extension, some bone material or tissue is removed to create space and to take pressure on tendons, for example.

However, British scientists now report in the journal "The Lancet" that could be dispensed with many interventions.

Improvement due to placebo effect

For their study, British scientists led by David Beard of the University of Oxford examined whether the surgery leads to greater pain relief than a sham surgery.

For this purpose, they divided the more than 300 study participants into three groups: around 100 subjects each underwent either the surgery or a sham procedure without ablation of bone material. The rest of the patients served as an additional control group.

The results: According to the scientists no measurable difference could be established between the two groups of operations. Although they performed slightly better than the untreated patients, this difference was not clinically relevant.

Researchers believe the improvement is due to the placebo effect.

Operation without clinical benefit

"The results of our study suggest that surgeries do not provide any clinically significant advantage over giving up treatment and that scapular enlargement is no better than a placebo procedure," study author Andrew Carr said in a statement.

His colleague David Beard, who also researches at Oxford University, said that, given the study's findings, it should focus more on "painkillers, physiotherapy, and steroid injections.".

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

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

The study of British scientists was also in Germany appeal. So the surgeon Felix Zeifang from the University of Heidelberg described the investigation according to a message from the news agency dpa as a "very well-wound up study".

According to the physician, the scapular operations are still being used too often despite previous scientific research, while conservative treatments such as physiotherapy would help at least two out of three patients.

"Only after months of unsuccessful conservative therapy is surgery to be discussed." (Ad)