Editorial Commentary: How to Reduce Postoperative Shoulder Pain in Your Practice-Stick to Instability and Opioid-Naive Patients

Abstract

Preoperative opioid use independently predicts persistent postoperative use after most surgical procedures, and surgery on the shoulder (and labrum specifically) is no exception. Thoughtful preoperative counseling of patients regarding the risks of continued postoperative opioid use, dangers of long-term narcotic use, expectations for postoperative pain control, and potential negative effect on postoperative outcomes is time-consuming and not easy. It is important to note that we have yet to determine whether preoperative opioid users can be restored to an opioid-naive state regarding the associated superior patient-reported outcomes observed postoperatively. Indications for surgery are important predictors of outcomes as well-athletes we treat for shoulder instability do not often present with pain unless associated with an acute instability event. Therefore, postoperative pain and opioid use are not commonly concerns if the indication for surgery is not pain related. The same cannot be said for SLAP tears.