RACHEL MARTIN, HOST:
OK. We're going to hear now about a popular remedy for shoulder pain. It's called arthroscopic surgery, but there's new research suggesting that this surgery isn't that effective. NPR's Patti Neighmond reports on a study published in the journal The Lancet.
PATTI NEIGHMOND, BYLINE: Every year, thousands of patients get surgery for shoulder pain. Now, these aren't necessarily patients who suffer pain as a result of a torn rotator cuff or another injury. It just hurts when they reach up to get something off a shelf, for example, or even when they try to scratch their back. It's not clear exactly what's causing the pain, but doctors think it may be the result of age-related tendon and muscle degeneration or changes in the bone and joint. Researcher David Beard with the University of Oxford.
DAVID BEARD: That has been discovered that maybe because they have an extra piece of bone, a bone spur and a closing of the space within the shoulder joint.
NEIGHMOND: In arthroscopic surgery, a surgical instrument is inserted through a small hole in the shoulder.
BEARD: To remove some of the bone and tissue, and that opens up the space a little bit, theoretically, and that should relieve the symptoms.
NEIGHMOND: That's the theory. But in Beard's study, it didn't turn out that way. He looked at nearly 300 patients in hospitals across the United Kingdom who had suffered shoulder pain for at least three months. Patients filled out questionnaires about pain and function. One third had no treatment at all. One third had fake surgery. A hole was made in the shoulder but nothing was done. The last third had the actual surgery, scraping out the area and removing extra bone.
BEARD: The two surgeries were almost identical. There was no difference between the placebo surgery and the surgery which took the bone and tissue away.
NEIGHMOND: And after six months, no difference in the surgery that tried to fix the problem and the surgery that didn't. Beard says the findings mean there needs to be some rethinking about when and if to do the surgery. Internist Richard Baron, president of the American Board of Internal Medicine Foundation, agrees.
RICHARD BARON: One of the most important questions every patient should ask any time they're thinking about or having a surgical procedure recommended is what happens if I don't do this? What are my options if I don't do this? Are there other things I might do than this?
NEIGHMOND: And in this case, Baron says, there are alternatives to surgery.
BARON: Medications, like anti-inflammatory medications that are available over the counter, and physical therapy is sometimes helpful. Another thing that's sometimes helpful is liniment - people rubbing on things that make the skin tingle, and there's a whole neurologic theory for why that helps with pain.
NEIGHMOND: But when none of this helps and people are still in pain, Dr. David Jevsevar, with the American Academy of Orthopaedic Surgeons, says surgery should still be an option.
DAVID JEVSEVAR: I think if you've gone a period of certainly more than six months with no improvement in your discomfort, it's a consideration to discuss with your surgeon.
NEIGHMOND: Jevsevar adds he'd like to see larger studies also looking at the effectiveness of this surgery for shoulder pain. Patti Neighmond, NPR News.
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