Subacromial Decompression Surgery
Musculoskeletal (MSK) Services
Last updated: July 2026
Next review: July 2028
What is Subacromial Decompression?
Subacromial decompression is a keyhole (arthroscopic) shoulder operation used to relieve pain caused by subacromial impingement syndrome. The procedure is usually recommended when non-surgical treatments such as rest, pain relief, physiotherapy and steroid injections have not successfully improved symptoms.
The aim of surgery is to create more space beneath the acromion (the roof of the shoulder), reducing pressure on the tendons and surrounding soft tissues during movement.
How Does the Surgery Work?
During the operation, your surgeon will:
- Remove inflamed tissue (subacromial bursa)
- Smooth or shave the underside of the acromion
- Increase the space around the rotator cuff tendons
If arthritis is present in the acromioclavicular (AC) joint, a small portion of the end of the collarbone may also be removed to further reduce pain.
Preparing for Surgery
Initial Consultation
Before surgery, you will attend an outpatient appointment where your shoulder will be assessed and treatment options discussed.
If surgery is recommended, you will attend a pre-operative assessment approximately 2–6 weeks before your procedure. During this appointment your surgeon will:
- Review your medical history
- Discuss the benefits and risks
- Explain the operation
- Answer any questions
- Arrange any required investigations
Depending on your medical history, you may also meet with an anaesthetist before surgery.
On the Day of Surgery
Subacromial decompression is usually performed as a day-case procedure, meaning most patients return home the same day.
Before surgery you should:
- Avoid eating or drinking for six hours beforehand
- Follow any medication advice provided by your hospital
- Arrange transport home after your operation
The procedure is carried out under general anaesthetic, with your anaesthetist monitoring you throughout.
Recovery After Surgery
Going Home
Most patients are discharged once they have fully recovered from the anaesthetic.
You will usually be provided with a sling, although it is intended for comfort rather than protection and can often be discarded within a few days.
Shoulder Exercises
Early movement is essential for a successful recovery.
A physiotherapist will teach you exercises before you leave hospital and provide written instructions to continue at home.
Although these exercises may initially be uncomfortable, they help restore movement and reduce stiffness.
Caring for Your Wound
The surgery is performed through two or three small incisions.
To help prevent infection:
- Keep dressings clean and dry
- Avoid soaking the wound until fully healed
- Follow advice regarding stitch removal if required
Contact your GP if you notice:
- Increasing redness
- Swelling
- Heat around the wound
- Fever or feeling generally unwell
Physiotherapy
You will normally attend outpatient physiotherapy around two weeks after surgery.
Your physiotherapist will:
- Assess your shoulder movement
- Progress your rehabilitation exercises
- Recommend further treatment if required
You will also attend a follow-up appointment with your surgical team approximately six weeks after surgery.
Recovery Timeline
Recovery varies between individuals, but general guidance includes:
| Activity | Typical Recovery Time |
|---|---|
| Driving | Around 1 week |
| Light office work | Around 2 weeks |
| Heavy manual work | Around 6 weeks |
| Vigorous exercise and sport | Around 12 weeks |
Most patients regain:
- Good shoulder movement by 6 weeks
- Shoulder strength by 12 weeks
Some discomfort may continue for several months and can take up to six months to fully settle.
Success Rates
Subacromial decompression generally provides good outcomes for appropriately selected patients.
Studies suggest:
- 75–80% of patients are satisfied with the results
- Around 70% return to normal function within 12 weeks
Recovery depends on several factors, including:
- Length of time symptoms have been present
- Severity of shoulder damage
- Rotator cuff health
- Shoulder mechanics
- Overall posture and muscle strength
Risks and Complications
Subacromial decompression is considered a safe procedure, although every operation carries some degree of risk.
Possible complications include:
- Ongoing shoulder pain
- Infection
- Delayed wound healing
- Small risk of tendon injury
- Rare reactions to general anaesthetic
If you have experienced problems with anaesthesia previously, tell your surgeon before your operation.
Frequently Asked Questions
Is subacromial decompression a day-case procedure?
Yes. Most patients go home on the same day.
Will I need to wear a sling?
Usually only for comfort during the first few days after surgery.
When can I drive again?
Most people can return to driving after approximately one week, provided they can safely control the vehicle.
How long does recovery take?
Most patients recover shoulder movement within six weeks and strength within 12 weeks, although complete pain relief can take up to six months.
Is physiotherapy necessary?
Yes. Physiotherapy is an important part of recovery and helps restore movement, strength and shoulder function.
