In May I posted a report on this topic. The British Medical Journal published a further article on this topic indicating that shoulder impingement surgery has little benefit in patients levels of pain, movement or quality of life when compared to other approaches.

The authors indicated that subacromial decompression surgery exposed patients to higher risk of harmful side-effects and only increased the expenditure for the health services.

In the face of mounting evidence, including a major UK clinical trial in 2017, the BMJ guideline group has published new advice for doctors which make a “strong recommendation against surgery”.

A quarter of adults have had shoulder pain in the last year, and subacromial pain syndrome, accounts for 70 per cent of cases. The condition is caused by a tendon rubbing nearby tissues when the arm is abducted. Seen more in over 40s, led to 21,000 surgeries in the UK 2010 and cost the NHS more than £50m.

Experts have now said that new evidence suggests that the operation does reduce pain or improve quality of life.

“Clinicians should not offer patients subacromial decompression surgery unprompted, and clinicians, public healthcare providers, and others should make efforts to educate the public regarding the ineffectiveness of surgery,” the authors wrote.

“The panel concluded that almost all informed patients would choose to avoid surgery because there is no benefit but there are harms and it is burdensome,” they wrote.

“However, there is substantial uncertainty in what alternative treatment is best.”

The BMJ guidelines were drawn up by an international expert group including orthopaedic surgeons, physiotherapists and patients with experience of the procedure.