Removing the sling reduces pain immediately after shoulder surgery

Background: A broad arm sling is traditionally applied following shoulder surgery for protection of repair and 'for comfort'. It has never been proved however that the use of a sling actually leads to reduced pain. The aim of our prospective study was to quantify a patient's immediate post-surgical pain with and without a sling, with the hypothesis being that it is in fact more comfortable not to have it on. Methods: Following surgery, a sling was applied as usual, and a pain score obtained within the first 4 hours. The sling was then removed and the score immediately repeated. The sling was left off until discharge, then used again as dictated by the nature of the surgery performed. Results: The mean pain score prior to sling removal was 4.59. The mean score following sling removal was 3.24, a mean reduction in 10-point Numerical Pain Scale of 1.35 points (p < 0.001). Sixty-two out of 85 patients experienced some reduction in pain after removal of the sling. No patient reported an increase in pain. Discussion: Our study shows that the simple action of allowing the operated arm to rest free of a sling reduces pain in the immediate post-surgical period.