Shoulder impingement syndrome – characterized by bursitis, inflammation, sometimes tearing of the rotator cuff, and bone spur formation in the shoulder -- produces pain and limits range of motion.
Symptoms include discomfort and, sometimes, acute shoulder pain when raising the arms above the head, reaching into a back pocket or while sleeping on the affected shoulder. People who frequently work with their arms above their heads may be more likely to get shoulder impingement syndrome.
What are my treatment options?
Before beginning treatment for shoulder pain, your doctor may take an X-ray. You doctor will also take a thorough history and examine you to ensure that the pain is not due to a problem in another area of the body.
Non-operative measures, including activity modification, physical therapy, anti-inflammatory medication, rehabilitation and, if appropriate, cortisone injection, are effective for more than 90 percent of patients in resolving the shoulder instability symptoms within three to six months of onset.
The doctor may suggest surgery for the patient who has not benefited from the non-operative management. The surgery may be performed arthroscopically or open, depending on which method the surgeon feels is more appropriate. This procedure improves function in about 85 percent of patients. The majority of cases are performed arthroscopically at Cleveland Clinic.
Arthroscopic subacromial decompression requires at least two 5mm incisions. The arthroscope is introduced through the skin and deltoid muscle to enter the shoulder joint. Once in the joint, a methodical inspection of the tissues is performed looking for tears in ligaments, muscles and tendons. Loose bodies may be found and an overall assessment of the joint surface is made. With this technique, the biceps tendon, rotator cuff tendons and joint can be examined for injuries that may not be evident on an MRI scan or with open surgery.
After the joint is examined, the arthroscope is withdrawn through the rotator cuff tendons and is placed in the space above the rotator cuff. It is in this space that the surgeon smoothes off the spur that is contributing to inflammation and impingement on the rotator cuff.
Arthroscopic surgery allows for a shorter recovery time and predictably less pain in the first few days following the procedure than does open surgery.