Shoulder Impingement Syndrome
Overview
This condition occurs when the tendons of the rotator cuff, along with the subacromial bursa, become compressed against a bony scapula protrusion called the acromion. As these tissues continually rub against bone, they become irritated and inflamed.
Causes
This condition is typically caused by excessive use of the shoulder. Occupations such as painting or construction, which require repetitive overhead motions, are common culprits.
Symptoms
Symptoms can include tenderness, swelling, reduced range of motion, and weakness in the shoulder. Minor pain may be present even when the shoulder is at rest. Sudden, sharp pain may be felt when the arm is used.
Treatment
Treatment options may include rest, anti-inflammatory medications, cortisone injections and physical therapy. If those methods do not relieve the symptoms, surgery may be needed to create space in the shoulder joint.
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Shoulder Impingement Surgery
Overview
This outpatient procedure relieves pain by decompressing the tight space around the rotator tendon of the shoulder joint. The surgeon removes the bursa and trims back the acromion bone to allow for normal pain-free motion. In most cases, this procedure is performed arthroscopically.
Incisions Made
The surgeon creates three small incisions in the shoulder to access the joint.
Fluid Pumped into Joint
A thin metal tube is inserted in one incision. Fluid is pumped through the tube and into the joint. This expands the joint, giving the surgeon a clear view and room to work.
Arthroscope Inserted
An arthroscope, which contains a light and a small video camera, is inserted into another incision. This gives the surgeon a clear view of the joint and the hooked acromion.
Swollen Tissue Removed
With the video images from the arthroscope as a guide, the surgeon inserts surgical instruments through the third incision. The swollen bursa tissue is removed.
Ligament Cut
Another surgical tool is inserted to cut away the impinging coracoacromial ligament.
Bone Shaved Away
The hooked portion of the acromion bone is shaved away, opening up the space above the supraspinatus tendon.
End of Procedure
After the joint is drained and the instruments removed, the incisions are closed using stitches or tape. The shoulder is bandaged, and within a few days, physical therapy will begin to help restore the shoulder to its full function.