Subacromial Decompression
Arthroscopic subacromial decompression and bursectomy with Dr. Steven Ward in Tucson and Oro Valley — making more room for the rotator cuff when shoulder impingement does not improve with therapy and injections.
Call 520-881-1394Typical ranges for general education. Dr. Ward’s plan for you may differ.
What it treats
The rotator cuff tendons glide under a bony roof on top of the shoulder called the acromion, cushioned by a thin sac called the bursa. When you raise your arm, that space narrows. If the bursa and tendons become inflamed, or a bone spur forms on the front of the acromion, they can pinch and rub. This is called impingement.
- Pain at the front or side of the shoulder, often spreading toward the upper arm
- Pain reaching overhead or behind you, and when lowering the arm
- Night pain that makes it hard to sleep on that side
- Subacromial bursitis and rotator cuff tendinitis that keep coming back
Is surgery right for you?
Most people with impingement improve without surgery, although it can take several weeks to months. Treatment usually starts with:
- Rest from overhead and aggravating activities
- Anti-inflammatory medication when it is safe for you
- Physical therapy to restore motion, then strengthen the rotator cuff and shoulder blade muscles and improve posture
- A steroid injection into the bursa if pain persists
Surgery is considered when pain continues despite these steps. Dr. Ward will also check the rotator cuff with an MRI or ultrasound, because a tear changes the plan.
How the surgery is done
Subacromial decompression is done arthroscopically through two or three small incisions, usually as an outpatient procedure with a nerve block and light general anesthesia.
Dr. Ward first looks inside the shoulder joint, then moves the camera into the space above the rotator cuff. He removes the thickened, inflamed bursa (bursectomy) and shaves down the bone spur on the front and underside of the acromion (acromioplasty). This creates more room for the tendons to glide.
Related problems are often treated during the same surgery, such as arthritis of the AC joint (where the collarbone meets the shoulder blade), biceps tendon inflammation, or a rotator cuff tear.
If a rotator cuff tear is found
If the rotator cuff is torn and repairable, it is usually repaired at the same surgery. Recovery then follows Dr. Ward’s rotator cuff protocol, which includes a longer period in the sling. See rotator cuff repair for that plan.
Recovery overview
Typical ranges after decompression without a rotator cuff repair. Dr. Ward’s plan for you may differ based on what is found at surgery.
Weeks 0–2
- Sling for a short time for comfort; it comes off as soon as you are comfortable
- Gentle shoulder motion begins early, along with hand, wrist, and elbow movement
- Ice and scheduled pain control as directed
Weeks 2–6
- Physical therapy works toward full range of motion
- Everyday use of the arm increases
- Avoid heavy lifting and repeated overhead work while the shoulder calms down
Months 2–4
- Rotator cuff and shoulder blade strengthening
- Gradual return to overhead work and sports as symptoms allow
- Complete pain relief typically takes 2–4 months and can take up to a year
When to call the clinic
Call 520-881-1394 if you notice any of the following after surgery or while you are recovering:
- A fever of 101°F or higher, or chills
- Redness spreading around an incision, or drainage that is cloudy, foul-smelling, or keeps soaking the dressing after the first few days
- New or worsening numbness, tingling, or weakness in the arm or hand once the nerve block has worn off, or fingers that turn pale, blue, or cold
- Pain that is not controlled by your prescribed medication, ice, rest, and the sling
- Swelling, pain, or tenderness in the calf or arm that is new or getting worse
It is normal for the shoulder and arm to feel numb for roughly 12–24 hours after a nerve block, and for the shoulder to be sore and bruised for a while. Call if something feels different from what you were told to expect.
for chest pain, shortness of breath, or trouble breathing. These can be signs of a blood clot in the lungs and need emergency care.
If something does not match the instructions you were given, call the office. Dr. Ward or one of his physician assistants will get back to you.
Related resources
Shoulder arthroscopy post-op
Wound care, pain control, ice, and early motion after arthroscopic shoulder surgery.
Open pageRotator cuff repair
What happens when a torn rotator cuff tendon is repaired, and the week-by-week rehab plan.
Open pageExercise guides
Printable home exercise programs to use with your physical therapist.
Open pageShoulder post-op hub
All of Dr. Ward’s shoulder packets, rehab protocols, and anatomy guides in one place.
Open pageOrthoInfo: Shoulder impingement
Patient education on impingement and rotator cuff tendinitis from the AAOS.
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