Shoulder impingement syndrome can be treated in a number of ways. Normally, the condition can be improved with oral anti-inflammatory medication (aspirin, ibuprofen). This medication should be taken for around 8 weeks to be effective.
Gentle daily stretching of the joint should help, and the joint must be rested whilst taking medication.
If symptoms persist, a cortisone injection direct to the affected area should reduce inflammation. Cortisone should only be used when oral anti-inflammatories have failed, as it may result in weakened muscles and tendons.
Symptoms can sometimes indicate a rotator cuff tear in which case a surgical repair may be necessary.
Most cases of impingement are successfully treated with anti-inflammatory medication, stretching and avoiding overhead activities until the condition has improved.
Impingement can be caused by various conditions, such as supraspinatus tendonitis and calcific tendonitis. If conservative management, including steroid injection fails then arthroscopic subacromial decompression is the treatment of choice.
Subacromial Decompression is a surgical procedure which aims to increase the amount of space between the rotator cuff tendons and the acromion. This takes pressure off the tissues under the acromion. The surgeon will remove any anterior and lateral bone spurs from the acromion which may be rubbing against the bursa and rotator cuff tendons. The CA ligament is divided. The acromion is then smoothed from lateral to medial; anterior to posterior.
The surgeon may also remove a small section of the acromion to provide yet more space for the tendons. Removing part of the acromion surgically is called acromioplasty. This is yet another measure to decompress (remove pressure) from the tissues between the acromion and the humerus bone.
If the shoulder joint is also affected by arthritis to the AC joint, a Resection Arthroplasty may be required in which the end of the clavicle (collar bone) may be removed.
Shoulder surgery requires a long rehabilitation period. Physiotherapy may be required and full recovery may take several months. A sling may be required directly after surgery, and ice, massage and other treatments may be required to ease pain.
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