Subacromial Decompression Surgery
in Rockhampton

What is going on

Subacromial bursitis and impingement are part of a spectrum of conditions involving the rotator cuff, the bursa above it, and the under-surface of the acromion. Patients describe pain on the outside of the shoulder, worse with overhead reaching, lifting away from the body, and lying on the affected side at night. The pain often radiates down the upper arm and can be sharp on certain movements. The underlying problem is some combination of bursal inflammation, partial cuff tendinopathy, and bony narrowing of the subacromial space — these are seldom separable and the term 'subacromial pain syndrome' is often used. The condition is more common after the age of 40, in occupations involving repetitive overhead work, and in throwing or racquet-sport athletes.

Not sure if this is the right diagnosis? The shoulder pain hub and shoulder injury hub triage the differential by anatomical location.

What the operation involves

**Arthroscopic subacromial decompression** removes inflamed bursa, smooths the under-surface of the acromion (acromioplasty), and addresses any concurrent pathology — partial cuff tear, calcific deposit, or AC joint arthritis. The procedure is typically done under regional and general anaesthesia as a day case, takes around 30 to 45 minutes, and is followed by a sling for comfort. Where a cuff repair is added, recovery becomes a rotator cuff repair recovery rather than a decompression-alone recovery. Full clinical detail is on the subacromial impingement education page and the rotator cuff disorders education page covers the broader picture.

For full clinical detail — incision, anaesthetic, post-operative instructions and the printable patient handout — see the subacromial decompression education page or the shoulder surgery overview.

How this case is handled

The practice's approach to subacromial pain emphasises the evidence: structured physiotherapy and a corticosteroid injection settle most patients without surgery. Where surgery is offered, the consult is explicit about what the operation is doing — debriding inflamed tissue, addressing concurrent pathology — and what published outcomes show. Patients with mixed pathology (cuff tear + impingement) often benefit more clearly than those with isolated impingement on imaging. Hand therapy and physiotherapy with Ruby Doolan at Extend Rehabilitation is built into the post-operative pathway.

Fees, Medicare rebates and the surgery-quote process are on the fees page. The case for seeing a fellowship-trained surgeon — and what fellowship training adds — is set out separately. GPs can find the referral pathway, urgency triage and what to include in the letter on the referrer page.

What this operation is billed under

The procedure is covered by the following Medicare Benefits Schedule items. Surgeon, anaesthetist, assistant, hospital and prosthesis fees are quoted separately and in writing before surgery — see the fees page for the practice's quote process and an explanation of why surgical fees follow the Australian Medical Association schedule. Surgery does not proceed without itemised written informed financial consent.

Item 48951 Arthroscopic subacromial decompression

The MBS item for arthroscopic decompression of the subacromial space

Patient questions we hear most

• Is shoulder bursitis the same as a rotator cuff tear?

  Not exactly, but they overlap. Subacromial bursitis is inflammation of the bursa above the rotator cuff; rotator cuff tendinopathy is degeneration of the cuff tendons themselves; rotator cuff tear is a structural tear of one or more cuff tendons. These conditions are part of a continuum and frequently co-exist — bursal inflammation often accompanies a cuff tear, and isolated bursitis can progress to tendinopathy and partial tearing over years. MRI helps distinguish them, but the consult's job is matching treatment to the dominant problem in any given patient.

• Will physiotherapy work, or do I need surgery?

  For most patients with subacromial pain — bursitis, impingement, or mild tendinopathy without a structural tear — structured physiotherapy works. Published trials over the past decade have repeatedly shown that arthroscopic decompression often does not outperform a thorough non-operative programme. That said, surgery has a clear role when there is a structural tear, a calcific deposit, an os acromiale, or persistent disabling symptoms despite a structured trial. The first consult sets out where the patient sits and what to try first.

• What does a corticosteroid injection do?

  A subacromial corticosteroid injection is a clinic-based procedure that delivers a small dose of steroid into the bursa above the cuff. It settles inflammation and reduces pain, often substantially, for weeks to months. It does not fix a structural tear, but it can break the pain cycle long enough for physiotherapy to make progress. Repeat injections are limited — usually no more than two or three at the same site — because of evidence that frequent steroid injections weaken tendons over time.

• How long is the recovery from decompression alone?

  After isolated arthroscopic decompression, most patients are out of the sling within a week and back to office work in seven to ten days. Driving is reasonable once the shoulder is comfortable. Physical activities and lifting are graded back over four to six weeks. Final settlement is usually around three months. Recovery is faster than after a rotator cuff repair because there is no tendon to protect.

• What if I also have a rotator cuff tear?

  If MRI shows a structural cuff tear, the operation typically combines decompression with cuff repair — see the rotator cuff repair page. The recovery follows the cuff-repair pathway: six weeks in a sling, gradual range-of-motion over the next six weeks, and strengthening over months. The decompression and repair are done at the same operation through the same arthroscopic portals.

• How much does shoulder bursitis surgery cost? What does Medicare cover?

  Arthroscopic subacromial decompression is performed under regional and general anaesthesia at Mater Private Hospital Rockhampton, so a separate anaesthetist gap applies on top of the surgeon and hospital fees. The practice quotes the surgical fee in writing before booking — Medicare item, rebate and out-of-pocket gap shown separately. Most major funds offer no-gap arrangements. Surgery does not proceed without itemised written informed financial consent.

More general questions about appointments, fees and the practice on the FAQ page.