Subacromial pain

Overview:

This how I like to refer to a group of shoulder problems because they give the same sort of pain and movement problems.

You may be told you have:

  • Bursitis (or subacromial bursitis)
  • Impingement (or subacromial impingement)
  • Tendonitis (or rotator cuff tendinitis)
  • Tendonopathy (or rotator cuff tendonopathy)

All theses conditions tend to cause pain that is felt in the upper arm. This pain is often worse at night and worse when using the arm. Tasks that require the arm to be lifted get harder, for instance hanging out washing.

 

Anatomy:

This pain comes from above the shoulder joint. From a area called the subacromial region.

In the picture below the subacromial region is the purple area.

Treatment:

Subacromial pain is very common, and often is self limiting.

Physiotherapy: If the pain persists then physio therapy is highly effective in most cases. This focuses on getting the shoulder working properly again and strengthening the muscles around the shoulder.

Injections: Steroid injections within the subacromial space can be very effective at reducing inflammation. For the injection to be effective it has to be accompanied by a course of physiotherapy.

Surgery: Subacromial decompression has become controversial in the treatment for subacromial pain. This can be highly effective, but it is not a first line treatment and should only be used in cases where the pain does not respond to injections and high quality physiotherapy.

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