Patients who are considering surgery should have attempted nonsurgical treatments for at least 3 to 6 months without improvement in symptoms. The symptoms should be causing difficulty with the patient's activities, and/or interfering with sleep at night.
How is surgery for shoulder bursitis performed?
The procedure used in the treatment of shoulder bursitis is called a subacromial decompression. This is an arthroscopic procedure performed using instruments inserted through small incisions. One of the instruments inserted is a video camera about the size of a pencil. Another instrument called a shaver is inserted through another incision. The shaver is used to remove the inflamed bursa. Once the bursa is removed, the rotator cuff is inspected to look for any signs of a tear.
Depending on the bone above the rotator cuff, a burr may be used to remove some bone to create more space for the rotator cuff tendons. Often there is a bone spur in this region that can pinch against the rotator cuff--thus the name impingement syndrome.
What is the rehabilitation following a subacromial decompression?
Patients are placed in a shoulder sling following surgery for impingement syndrome, but they can begin shoulder motion quickly. Unlike surgery for a rotator cuff tear, there is no need for a period of restricted motion to allow the tendon healing. In cases of an isolated subacromial decompression, patients can begin gentle motion immediately after surgery. Strengthening can begin within a few weeks, and sports can resume after the swelling has subsided.
Bigliani LU, Levine WN. "Subacromial impingement syndrome" J Bone Joint Surg Am. 1997 Dec;79(12):1854-68.
Izquierdo R, et al. "Arthroscopic acromioplasty" Instr Course Lect. 2004;53:13-20.