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Dr Joerg Rhau, Orthopaedic Surgeon, Brisbane, Greenslopes, Cleveland, Beenleigh, Mackay, QLD // Shoulder // Subacromial Impingement Syndrome

Subacromial Impingement Syndrome

I have a painful Shoulder?

Shoulder pain can be categorised by a number of factors and conditions, one condition is Subacromial Impingement Syndrome. This condition is also known as subacromial bursitis and involves constant pain, night pain and pain when lifting the arm. It affects the bursa which is a thin fluid film between the bony shoulder roof (acromion) and the underlying rotator cuff tendons.

Who Suffers From Subacromial Impingement Syndrome?

Subacromial Impingement Syndrome can affect all age groups, however it is more common in middle-aged patients. The pinching pain is caused by an inflammation of the bursa (bursitis) that can be brought on by trauma, overuse or degeneration.

Symptoms of Subacromial Impingement Syndrome

Common symptoms of Subacromial Impingement Syndrome are

  • Pain (constant or at night)
  • Inability to raise the arm
  • Stiffness may also occur in later stages

Causes of Subacromial Impingement Syndrome

Subacromial Impingement Syndrome can be caused by:

  • Traumatic (strain, contusion)
  • Degenerative changes (calcium, bony spurs, ligament thickening)
  • Overuse
    Sometimes bursitis is due to a reaction to calcium deposits (calcific tendinosis). Inflammation arises and the bursa gets thicker and becomes an impinging structure. The coracoacromial ligament, which runs across the front of the shoulder joint occasionally grows thicker and causes impingement.

Diagnosis of Subacromial Impingement Syndrome

Diagnosis is made by:

  • Clinical examination
  • Ultrasound, radiographs or MRI

If you had any of these studies done, please bring them with you at your appointment.

Non-Surgical Treatments for Subacromial Impingement Syndrome

Often subacromial impingement syndrome can be treated successfully by:

  • Physiotherapy
  • Steroid injections and
  • Anti-inflammatory medication

Surgical Treatments for Subacromial Impingement Syndrome

In chronic cases of Subacromial Impingement Syndrome where non-surgical treatment has failed, surgery is an option.

This is usually done as a day case under general anaesthesia via arthroscopy (keyhole surgery). During this procedure the following occurs:

  • Two or three 5mm incisions are made around the shoulder.
  • The inflamed bursa tissue is removed and with it the impingement.
  • Other impinging structures such as calcium deposits, bony spurs or a thickened coracoacromial ligament are also removed.
  • A new bursa will grow back within a few weeks.

Preparing for Rotator Cuff Repair Surgery

Prior to the procedure, we will arrange for one preconditioning physiotherapy session where we fit a shoulder immobiliser, explain some simple exercises and give you an ice bladder with icing instructions. If required we will also arrange for a bulk billed pre admission clinic at the hospital. This is run by a specialist anaesthetist who will gather information and investigations that are required for safe anaesthesia. Our reception staff will advise of costs, hospital and admission details.

Recovery From Subacromial Impingement Surgery

Following the procedure, physiotherapy is advisable in order for the quickest possible recovery. Depending on the individual occupation or desired tasks overall recovery may take between 2 and 12 weeks.