Shoulder surgery

It is important to note that shoulder surgery can be major surgery. If you are advised to have surgery for your shoulder problems, your Orthopaedic Surgeon will explain what this will involve, including how to prepare for your surgery, what happens during your procedure, its risks and benefits and what to expect during your recovery. Our team of dedicated specialists will support you through every step of your healthcare journey, including during your recovery, to ensure you get the best possible outcome from your shoulder surgery.

If you are suffering from shoulder problems, your consultant may start with treatments such as pain medication and steroid injections to provide pain relief and reduce inflammation in your affected joint. Your consultant may also recommend physiotherapy to ease your symptoms and improve strength, flexibility and range of motion. People of all ages can benefit from physiotherapy, which can involve exercises to strengthen your shoulder, relax your muscles and joints and relieve stiffness and pain. 

If physiotherapy, steroid injections, and pain relief medication have not helped alleviate your symptoms, your consultant may recommend shoulder surgery.

Some common reasons why you might need shoulder surgery include: 

Osteoarthritis

Osteoarthritis impacts an estimated ten million people across the UK. It occurs when the cartilage that covers the ends of your joints breaks down. As a result, the ends of the bones that form your joint begin to rub together causing pain, inflammation and stiffness. 

Rheumatoid arthritis

This less common form of arthritis affects around 1% of the UK population. It is caused by your immune system attacking the cells that line your joints, leading to swelling, pain and stiffness in your joints including possibly your shoulder joint. 

Frozen shoulder (adhesive capsulitis)

A frozen shoulder occurs when the connective tissue in your shoulder joint thickens and tightens causing pain and stiffness and making movement difficult. Frozen shoulder normally gets gradually worse over time before slowly improving over between one and three years.

Rotator cuff tear

Your rotator cuff tendon can tear following an injury such as a shoulder dislocation, overuse of your shoulder from activities such as sport, or as part of wear and tear of the tendon due to ageing. Rotator cuff repair surgery is a procedure to repair the tear in your rotator cuff. 

Shoulder impingement

If your rotator cuff tendon rubs against your acromion (the bony part of your shoulder blade) when you raise your arm, you may be suffering from shoulder impingement. A shoulder impingement can occur due to irritation or inflammation in the bursa (fluid-filled sac) located between your rotator cuff tendon and acromion, or following a tear in your rotator cuff tendon (rotator cuff tear).

Shoulder instability

Shoulder instability can be caused by dislocation, an injury where your humeral head is completely removed from its socket, or subluxation (when your joint is only partially out of place after an injury).

The cost of private shoulder surgery with Circle Health Group starts from around £5,970.

The cost of having shoulder surgery at our hospitals will vary depending on your chosen hospital, diagnosis, and the procedure that you need. 

It is important to note the above is only a guide price. The final cost of your treatment will be confirmed in writing and will include the cost of all your anaesthesia, surgery and aftercare. 

At our hospitals, we offer many flexible payment options to help cover the cost of your treatment. For further information, please visit our payment options page.

Common symptoms that can indicate the need for shoulder surgery include:

Sudden, severe shoulder pain

Sudden, severe shoulder pain following an impact or injury may indicate a shoulder fracture or dislocation in your collarbone (clavicle) or shoulder joint, or a rotator cuff tear. Sudden shoulder pain without a preceding injury can have several causes including tendonitis, bursitis, a pinched nerve, arthritis, or frozen shoulder. Sudden, severe pain in your shoulder can also be referred from other parts of your body such as your heart or lungs and can be a sign of a heart attack, heart inflammation (pericarditis) or pneumonia.

If you have a fracture or dislocation, you may need surgery to realign and stabilise any broken bones or move your shoulder bones back into their correct position. If you have torn your rotator cuff, you may need an operation to attach your rotator cuff tendon back to your humerus.

Shoulder pain that worsens when you use your arm or shoulder

This can be a symptom of shoulder impingement or bursitis (which happens when a small sac around your joints becomes inflamed, causing swelling and pain). If you have severe or reoccurring bursitis, your Orthopaedic Consultant can perform surgery (shoulder bursitis surgery) to remove or drain your bursa. If your symptoms are caused by shoulder impingement, arthroscopic shoulder surgery may be recommended to examine your shoulder joint, identify the cause and relieve your symptoms.

Persistent pain or stiffness

Chronic pain or stiffness can be caused by osteoarthritis, rheumatoid arthritis, or a frozen shoulder. Comprehensive arthroscopic management (CAM) is a type of keyhole surgery that is used to treat pain and shoulder stiffness induced by arthritis. If you have severe arthritis, your Consultant might recommend shoulder replacement surgery, which involves replacing your damaged joint with an artificial one (prosthesis).

Numbness or weakness in your shoulder

This can be caused by shoulder instability due to a dislocation or hypermobility (increased flexibility in your joints).

At your first appointment, you'll meet your consultant Orthopaedic surgeon, the doctor responsible for your care. Your consultant will start by asking you about your symptoms, general health, medical history and any medications you take regularly. They will perform a thorough physical examination. They may ask to see the results of any tests or scans you've had previously, or they may arrange them on the day. These may include a blood test, X-ray, CT or MRI scan.

At the end of your appointment, your surgeon will discuss possible treatment options with you, based on your symptoms, diagnosis and expectations for treatment. 

If you are advised to have shoulder surgery, your Orthopaedic Surgeon might advise making some lifestyle changes to prepare for your surgery. This may include: 

Quitting smoking

Smoking can increase your risk of experiencing post-operative complications, such as wound infections and deep vein thrombosis or DVT (a blood clot in your vein). If you smoke, your Consultant will provide you with information and support to help you quit smoking ahead of your surgery.

Stopping hormonal medication (for women)

If you are on the oral contraceptive pill, you will need to stop taking the pill at least four weeks before your operation due to the increased risk of deep vein thrombosis (DVT). Medication such as hormone replacement therapy might also need to be stopped, especially if you are at higher risk of experiencing DVT.

Stopping certain medications

Your consultant may advise you to stop taking certain medications, such as blood thinners for a few days before your shoulder surgery. This is to reduce the risk of bleeding during and after your operation.

Following a healthy diet

Following a healthy, nutritious diet and ensuring you are at a healthy weight before your surgery can reduce the risk of complications and allow your recovery to go more smoothly.

Attending a preoperative assessment

Before your shoulder surgery, you will need to attend the clinic for a pre-operative assessment, which is a general health check to ensure you are fit for surgery. You will need to bring your current medications with you to your assessment. During your pre-operative assessment, a nurse will check your blood pressure and weight. You may also have a blood test, chest X-ray and echocardiogram (ECG) to evaluate your general health at your assessment.

Things to remember before your surgery

• Bring your current medication to your assessment and surgery
• Avoid wearing any jewellery or nail varnish, as this will need to be removed before your operation
• If you are having a general anaesthetic, you will not be able to eat or drink anything from midnight on the day of your operation
• You will need to arrange for someone to help you at home with tasks such as cooking, cleaning, shopping and driving for several weeks after your shoulder surgery

What happens during your shoulder surgery depends on the type of surgery you are having. Your consultant will explain your procedure to you and answer any questions you may have before your surgery.

Shoulder arthroscopy

Arthroscopic shoulder surgery is a minimally invasive procedure that can be used to diagnose conditions causing chronic shoulder pain and stiffness. 

Shoulder arthroscopy is usually performed under general anaesthetic, meaning you’ll be asleep for the procedure. In some cases, you may be given a local anaesthetic or nerve block to numb your shoulder and arm, which means you’ll be awake for your surgery but won’t feel any pain during your operation. 

During shoulder arthroscopy, a thin flexible tube with a small camera called an arthroscope is passed through a small incision (cut) on the back of your shoulder. Once the arthroscope is passed into your shoulder, the camera transmits images to a video monitor, which allows your Surgeon to examine the inside of your shoulder joint. Your Surgeon will then make one to three further incisions and insert specialist surgical instruments to remove or repair any damage to the structures in your shoulder joint. The incisions are then closed with stitches and a sterile dressing and bandage are applied to your surgical wound.

Arthroscopic surgery can be performed for many shoulder procedures, including: 

Rotator cuff surgery

A rotator cuff repair may be carried out during an arthroscopy to reattach your torn rotator cuff tendon to your humerus (upper arm bone). In addition to a general anaesthetic, you may be given a local anaesthetic to alleviate pain following your rotator cuff surgery. 90% of patients who undergo rotator cuff repair surgery experience improvement in their pain and an increased ability to move their shoulder.

Arthroscopic subacromial decompression (shoulder impingement surgery)

When you raise your arm, your rotator cuff tendon passes through an arch known as your coracoacromial arch. If your rotator cuff tendon rubs against the acromion (a bone that forms this arch), it can cause shoulder impingement, which can lead to pain, inflammation, or a tear in your rotator cuff tendon. Subacromial decompression surgery uses an arthroscopy technique to release the ligament in this arch and shave the surface underneath your acromion. This allows your rotator cuff tendon more room to move and reduces pain. 

Shoulder manipulation under anaesthetic (MUA)

Frozen shoulder occurs due to a problem in the capsule (lining) that covers your shoulder joint, causing your capsule to become inflamed and stiff. Shoulder manipulation through arthroscopy is a surgical technique that aims to increase the range of movement in your shoulder and help alleviate your symptoms. During MUA, a saline solution is inserted into your shoulder joint to stretch your capsule. Your consultant then surgically releases your tight capsule and manipulates your shoulder joint to restore movement in your joint. 

Comprehensive arthroscopic management (CAM)

Comprehensive arthroscopic management uses arthroscopic surgery to treat parts of your shoulder that are affected by arthritis. The first stage of this treatment involves removing any damaged labrum tissue (a rim of cartilage around your shoulder joint’s socket). Your Surgeon will then smooth the bone within your joint and release any scarred tissue near your humerus. The final stage of the surgery involves relieving pressure from the auxiliary nerve (the nerve that is associated with arthritic shoulder pain). 

Shoulder stabilisation surgery

After a dislocation or subluxation, you may have torn or stretched ligaments in your shoulder and the rim of cartilage around your joint’s socket might be damaged. Shoulder stabilisation surgery such as Latarjet shoulder stabilisation surgery involves repairing the damaged cartilage and tightening any stretched ligaments. 

When is open surgery recommended?

Some types of orthopaedic surgery cannot be performed arthroscopically (as keyhole surgery) and some procedures such as shoulder replacement surgery need to be done as open surgery. Open surgery involves making a single incision of around 7cm in the front of your shoulder. Open surgery may also be used to perform shoulder stabilisation surgery.

How long does a shoulder arthroscopy take?

Shoulder arthroscopy normally takes around 60 to 90 minutes, but the total length of your surgery depends on your diagnosis and the type of shoulder surgery you have.

After your shoulder surgery, you will be taken to the recovery room, where you will be monitored closely until the effects of the anaesthetic have worn off. When you wake up, your arm will be immobilised in a sling while it heals.

Your consultant will explain how long you need to wear the sling and how to care for your surgical wounds.

Arthroscopic (keyhole surgery) is normally performed as an outpatient procedure, meaning you can usually go home the same day. If you had open surgery, you may need to spend one night in hospital.

It's normal to experience some pain or discomfort after your shoulder surgery. Your healthcare team will give you pain medication to manage this.

Before you go home, you will meet with a physiotherapist who will provide you with an individualised exercise plan to support your recovery at home. These exercises could include shoulder elevation exercises which involve lifting both arms above your head to improve your flexibility and range of motion. Your Physiotherapist might ask you to repeat these exercises at least two to three times a day while recovering at home.

You will not be able to drive yourself home from the hospital or operate machinery for at least 24 hours after your shoulder surgery. Please arrange for someone to collect you from the hospital when you are discharged.

During your recovery at home, you will be advised to remove your sling when showering, getting dressed or performing your shoulder exercises. If you are finding it difficult to sleep with a sling, sleeping on your back, propped up with two or three pillows and your arm resting on a pillow may help.

Do not drive until you can safely control your vehicle and perform an emergency stop. When you can drive after your shoulder surgery depends on the type of surgery you had and ranges from one to two weeks following minor surgery, six to eight weeks after major surgery and up to 12 weeks after rotator cuff surgery. You can normally drive when you can comfortably move your shoulder and no longer require a sling. Do not drive while taking strong painkillers or other medications that could affect your concentration and impair your reaction times.

When you can return to work depends on the type of surgery you had, your individual recovery and the type of work that you do. How long you need to take off work after your shoulder surgery ranges from two weeks to around four months.

As with any type of surgery, there is a small risk of complications associated with shoulder surgery. Your consultant will explain these to you before your procedure and answer any questions you may have to allow you to make an informed decision. Potential risks and complications of shoulder surgery include:  

Infection: If you develop an infection after your shoulder surgery, this can be treated with antibiotics 

Blood clots: You will be asked to move around as much as possible after your operation and may need to wear compression stockings to minimise your risk of blood clots

Swelling and bruising around your wound: You may have some bruising or swelling around your surgical wound but this will resolve with time

Scarring: There might be small scars at the site of your incision(s). Most scars fade and become less noticeable over time.

Adverse reactions from the anaesthetic: Rarely, you may experience an adverse reaction to the general anaesthetic. This is usually mild but may be serious. If you have a bad reaction to the anaesthetic, the medical team will be on hand to provide immediate treatment.

If you are struggling with shoulder problems, we provide fast access to effective treatment, tailored to each individual. Our specialists will be there to support you throughout your healthcare journey, from your initial appointment, right through to your return to your everyday life.

If you would like to learn more, book your appointment online today or call a member of our team directly.

Content reviewed by Circle in-house team in March 2025. Next review due March 2028

1. Subacromial decompression, Royal Orthopaedic Hospital
2. Shoulder arthroscopy, OrthoInfo
3. Rotator cuff repair, Johns Hopkins Medicine