Shoulder impingement or impingement syndrome occurs when your acromion, the bone on top of your shoulder, rubs against or impinges on the tendon and the bursa. The bursa is a lubricating sac between the rotator cuff and acromion that enables the rotator cuff to glide freely when you move your arm. Impingement happens when the space between the acromion and rotator cuff narrows as you raise your arm to shoulder height. It is the rotator cuff that is the common source of pain in the shoulder as it relates to the impingement. If left untreated, a rotator cuff tear can occur. Shoulder impingement causes a dull, consistent pain, especially with overhead motions and can worsen in the evening or when trying to sleep.
Impingement syndrome can easily be misdiagnosed for many other conditions such as frozen shoulder, biceps tendonitis, and arthritis. Dr. Stowell will do a thorough physical and medical history examination with possible X-rays or even an MRI to accurately diagnose your condition.
Nonsurgical treatments that Dr. Stowell may recommend to treat your pain include:
- Non-steroidal anti-inflammatory medication like aspirin or ibuprofen.
- Steroid injections like cortisone.
- Therapeutic exercises.
If nonsurgical treatments fail to resolve your problem, Dr. Stowell may perform an arthroscopic surgery called acromioplasty also known as subacromial decompression surgery. He will widen the space above and around the rotator cuff and debride the bursa and the tissues that are inflamed. This relieves pressure by expanding the room for soft tissues surrounding the rotator cuff. Many times, this procedure along with another surgical procedure like a rotator cuff repair is performed to treat the area near the symptoms responsible for your pain.
After your acromioplasty surgery, you will go home with a sling to wear for several days. Ice packs will need to be applied intermittingly to reduce swelling and relieve discomfort. Dr. Stowell will advise you of your post-op management instructions and may suggest physical therapy that will exercise your range of motion below the shoulder level for the first few weeks of recovery.
Within four to six weeks, you should be able to resume normal activities as long as you strictly adhered to avoid motions that would stress your joints and tendons like throwing, lifting, and swimming. After six weeks, Dr. Stowell may recommend a moderate strengthening program that include exercises above your shoulder. Recovery from shoulder impingement treated with an acromioplasty surgery usually takes about three to six months to heal completely. More challenging cases may take longer up to a year for full recovery.