This month we will be covering a condition called subacromial impingement. This is where the tendons that make up the back of the rotator cuff muscles become inflamed. They get trapped between the roof of the shoulder (the acromion) and the head of humerus (top of the main arm bone). This often leads to an inflammation of two main muscles of the posterior (back part) of the rotator cuff, namely, supraspinatus and infraspinatus. These muscles are absolutely key in normal shoulder movement.
Typically, a patient suffering from this condition will have pain down the side of the upper arm and sometimes difficulty lying on that shoulder at night. This condition can sometimes be intrusive to normal sleep pattern. At this point, analgesics (painkillers) and NSAIDs (anti-inflammatories) can be helpful if tolerated and safe.
When this condition is untreated it can lead to degeneration of the cuff tendons and more serious pathology of the area.
The treatment pathway for this condition is either conservative management i.e., physiotherapy and exercise rehab, or when more serious a surgical procedure called a subacromial decompression. Prior to surgery a shoulder specialist will often use injections to see if this resolves the condition and will use an MRI as a diagnostic tool.
It is very important to intervene at an early stage with the correct physiotherapy measures, to prevent surgery or injective therapy being required.