Shoulder arthroscopy

Your health expert: Mr Damian McClelland, Trauma and Orthopaedic Surgery Consultant
Content editor review by Victoria Goldman, December 2023
Next review due December 2025

Expert reviewer, Mr Damian McClelland, Trauma and Orthopaedic Surgery Consultant
Next review due December 2025

Shoulder arthroscopy is a type of keyhole surgery used to see, diagnose and treat problems in your shoulder. Your surgeon uses a tiny camera to look inside your shoulder joint.

When is shoulder arthroscopy recommended?

Your doctor may suggest you have shoulder arthroscopy if you’re getting pain or stiffness in your shoulder from:

an injury
an infection in your shoulder
arthritis
other shoulder problems

Having shoulder arthroscopy can help you move your shoulder more easily. This may help you sleep better and improve your quality of life too.

Having shoulder arthroscopy rather than open surgery may mean you have:

a shorter hospital stay
smaller scars afterwards
a quicker recovery time
fewer complications

Preparing for shoulder arthroscopy

Your surgeon will explain how to get ready for your procedure. If you smoke, you’ll be asked to stop smoking before your surgery. Smoking makes you more likely to get a chest or wound infection after surgery. This can slow down your recovery. It can also make your surgery less effective and lead to complications.

Shoulder arthroscopy is usually done as a day-case procedure in hospital. This means you have the procedure and go home on the same day.

Your surgeon will discuss with you what will happen before, during and after your procedure, including any pain you may have. If you’re unsure about anything, don’t be afraid to ask. No question is too small. It’s important that you feel fully informed and are happy to give your consent for the operation to go ahead. You’ll be asked to do this by signing a consent form.

Having an anaesthetic

You’ll usually have a general anaesthetic for a shoulder arthroscopy. This means you’ll be asleep during the operation. Sometimes, your surgeon may use a combination of both local and general anaesthetics. You have the procedure under general anaesthetic, but your surgeon injects a local anaesthetic before you wake up. The anaesthetic is injected into the nerves that give you movement and sensation in your shoulder. This helps to control pain in your shoulder afterwards.

If you can’t have a general anaesthetic for any reason, your surgeon may be able to do your arthroscopy using a nerve block. You’ll have an injection of local anaesthetic around the nerves that control your shoulder. This makes your arm completely numb. You won’t feel anything during the procedure but you’ll be awake. Ask your surgeon if you’d like something to make you drowsy and help you relax.

If you’re having a general anaesthetic, you’ll be given instructions about not eating or drinking for a certain number of hours before your surgery. This is for your own safety while you’re under anaesthetic so it’s important to follow your anaesthetist’s advice.

What happens during shoulder arthroscopy?

You may have the surgery sitting in a ‘deckchair’ position or lying on your side.

Once the anaesthetic has worked, your surgeon will make small cuts in the skin around your shoulder joint. They’ll put the arthroscope (a small tube) in through one of these cuts. The arthroscope contains a tiny camera. Your surgeon uses the arthroscope to look inside your shoulder joint. They may inject some saline (salt water) into your joint to help them get a clearer look.

Your surgeon will examine your shoulder joint by looking at images from the camera on a monitor. If there’s any damage in your shoulder, they’ll use surgical instruments to repair it. Your surgeon will also take out any damaged tissue that stops you from moving your shoulder properly and causes pain.

Afterwards, your surgeon will close the cuts with stitches or sticky plasters. They’ll then wrap a dressing and a bandage around your shoulder.

What to expect afterwards

You’ll need to rest until the effects of the anaesthetic have worn off. You may have some discomfort as the anaesthetic wears off. Do tell your nurse so you can have the pain relief you need.

You’ll usually be able to go home when you feel ready. But you'll need to arrange for someone to drive you home. If you live alone, you must have a responsible adult to stay with you for the first 24 hours.

Having a general anaesthetic or sedative affects everyone differently. You may find that you’re not so coordinated or that it’s difficult to think clearly. This feeling should go away within 24 hours. In the meantime, don’t drive, drink alcohol, operate machinery or sign anything important. Always follow your surgeon’s advice.

Your nurse will give you some advice about caring for your wounds before you go home. They should explain how and when the stitches will be removed if they need to be. This would usually happen around 10 to 14 days after your operation. You may also be given a date for a follow-up appointment with your surgeon.

Recovering from shoulder arthroscopy

If you had a local anaesthetic injection, it may be up to 24 hours before the feeling comes back completely into your shoulder. Take special care not to injure your arm while you wait for the feeling to come back. If you can’t feel your arm properly, you may be more likely to hurt it accidentally.

You may be advised to keep your arm in a sling after the operation. This will keep your shoulder in the correct position to recover properly and protect it from further damage. Your surgeon will tell you how long you need to wear a sling for.

Your shoulder joint is likely to feel sore and stiff after surgery. Some people find lying down at night pulls their shoulder and is uncomfortable. You may find it more comfortable to sleep propped up at first, either in bed or in a reclining chair.

You may struggle to dress and wash yourself at first – you may want to ask your partner, a relative or friend to be on hand to help you. The first few weeks will be the most difficult – it should start to get easier after this.

Pain relief

You may have some pain or discomfort for several weeks after your shoulder arthroscopy.

You may be given some painkillers to take home when you leave hospital. Or you can take over-the-counter painkillers, such as paracetamol or ibuprofen. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist for advice.

Applying a cold compress, such as an ice pack or a bag of frozen peas wrapped in a towel may help to reduce swelling and bruising. But don’t apply ice directly to your bare shoulder as it can damage your skin.

Regaining movement

Your physiotherapist will recommend some exercises and advise you when to start doing them. Doing these regularly will help your shoulder to heal and may help you to recover more quickly.

It may take you several weeks to several months to recover from shoulder arthroscopy. Most people get full movement of their shoulder back afterwards, but this can take several months. Ask your surgeon if you have any queries about restarting specific activities, and always follow their advice.

Driving after shoulder arthroscopy

You don’t need to notify the Driver and Vehicle Licensing Agency (DVLA) about your surgery as long as your recovery doesn’t affect your ability to drive. But it’s important to speak to your surgeon about when you can go back to driving safely after your operation.

Your driving may be affected by:

temporary muscle weakness, pain and stiffness in your shoulder – especially if you drive a manual car
taking painkillers that make you drowsy or stop you thinking clearly
whether you need to wear a sling

It may take some time before your shoulder recovers enough to feel safe driving – perhaps weeks or months. You’ll need to check that you’re covered by your insurance too.

Side-effects

Side-effects are the unwanted, but mainly temporary, effects you may have after a procedure. Some specific side-effects of shoulder arthroscopy are:

small scars on your shoulder, where the surgeon made the small cuts to put in the camera and instruments
pain and stiffness around your shoulder

How long pain and stiffness will take to go varies from person to person. Your exercises will help you to get your movement back. They’ll also strengthen your shoulder and get rid of any stiffness. You can help yourself recover by doing these as often as your doctor or physiotherapist has recommended.

Complications

Complications are when problems occur during or after a procedure. Most people who have a shoulder arthroscopy don’t get any problems, but all procedures carry some risk.

Complications of arthroscopy include:

an infection
excessive bleeding into your joint
damage to surrounding blood vessels or nerves
getting a blood clot in one of your leg veins (deep vein thrombosis)
occasional stiffness (frozen shoulder) which can usually be helped with physiotherapy

Ask your surgeon whether you’re at a particular risk for any complications, because of your individual circumstances.

What are the alternatives to shoulder arthroscopy?

Shoulder arthroscopy may be used to diagnose shoulder problems, or to treat them.

Diagnosis

Not everyone who has a problem with their shoulder will need to have arthroscopy. Your doctor will usually be able to diagnose your shoulder problem by examining you. You may also need to have some imaging tests, such as

an X-ray
an ultrasound
a magnetic resonance imaging (MRI) scan

Treatment

The best treatment for your shoulder problem will depend on:

how much damage there is to your shoulder
how long your shoulder has been troublesome
how much it affects you day-to-day

Sometimes, your symptoms will get better on their own without any surgical treatment. Your doctor may suggest:

ice packs
anti-inflammatory medicines
stretching exercises

Once you’re able to move your shoulder again without pain, you can start exercises to strengthen the muscles around your shoulder. This is usually around four weeks later. Your doctor may refer you to a physiotherapist for help with the exercises.

Another treatment that can be helpful for shoulder problems is a steroid injection. Talk to your doctor about which treatment options are right for you.

Looking for physiotherapy?

You can access a range of treatments on a pay as you go basis, including physiotherapy.

To book or to make an enquiry, call us on 0370 218 6528^∧

Find out more about physiotherapy

Everyone recovers differently from shoulder arthroscopy surgery. It may take several weeks to several months to recover from shoulder arthroscopy. Most people get their full movement back again eventually. For more information, see our section on recovering from shoulder arthroscopy.

A shoulder arthroscopy is keyhole surgery rather than open surgery. You’re likely to have a shorter hospital stay, a quicker recovery time and fewer complications afterwards. But you usually still need to have it done under a general anaesthetic.

You won’t feel pain during the operation as you’ll have an anaesthetic. But you’re likely to have some pain and stiffness after surgery. For more information, see our recovering from shoulder arthroscopy section.

Speak to your surgeon about when you can go back to driving safely after your operation. Your ability to drive will be affected by how quickly you recover and whether you’re taking strong painkillers. See our recovering from shoulder arthroscopy section for more information.

You’ll usually have a general anaesthetic for shoulder arthroscopy. This means you’ll be asleep during the operation. But sometimes you may be able to have a nerve block instead. You’ll be awake but won’t feel anything. See our preparing for shoulder arthroscopy section for more information.

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