Positive outcomes in subacromial decompression and sham surgery for shoulder pain may be attributable to post-operative care, physical therapy, rest, and the placebo effect.

“when both groups get better his argument was the only ethical thing you can do as a surgeon is to offer the Sham surgery the problem is if you offer it as a sham you might lose the benefit right so you can't do that but then you are duping the patient taking them to an operating room for what they consider to be a procedure that's a procedure when in fact unless you explain to them that look the reason we would explain the equivalence of the Sham to the procedure is the post-operative care that you got it's the PT it's the or it's some combination of the rest the post port the for stress from the first arrest and the forced PT because you're gonna take PT way more seriously when you're in a sling and you've had surgery right”