Surgery – placebo or justified? Surgery – placebo or justified? Shoulder surgery for pain - placebo or justified?

Researchers in Oxford are hoping to find out if a commonly-performed operation used to treat shoulder pain actually works – or whether its success can be attributed to the placebo effect.

The use of a surgical technique called arthroscopic sub-acromial decompression has increased by more than 700 per cent in the past ten years but there is no hard evidence to show how effective it is. There is a growing concern that the vast increase in the frequency of the operation being performed needs to be justified.

Now a team at Nuffield Orthopaedic Centre are comparing the effectiveness of the operation with a placebo operation as there are a number of conflicting views about the effectiveness of surgery for shoulder pain.

While some reports show that arthroscopic or keyhole surgery is no more effective than physiotherapy to relieve pain, others show that it can be helpful and provide a useful treatment option. Other results suggest that removing a piece of bony spur from the shoulder - a procedure known as decompression – during surgery may be unnecessary, and that actual process of undergoing investigative arthroscopy can in itself produce benefit.

“The fact that a period of no treatment can also be beneficial for patients completes a rather confused picture,” added Ms Cooper. “It’s quite clear that we need to perform some definitive studies to show what really helps people with this type of shoulder pain. Pressures in the NHS are such that surgeons are being encouraged to prove the benefits of their practice, so that’s what we hope to do in this study.”

Surgery should be the last choice for sufferers of shoulder pain with many effective treatments available. The Bowen Technique helps the body remember how to heal itself. The gentle yet powerful Bowen moves send neurological impulses to the brain resulting in immediate responses of muscle relaxation and pain reduction. The moves create energy surges.  Electrical impulses sent to the nervous system remind the body to regain normal movement in joints, muscles and tendons. This helps relieve muscle spasms and increase blood and lymph flow.