Shoulder Impingement Syndrome is medical condition where there is swelling of the rotator cuff tendons and the surrounding bursa, with immense pain. This is also called Rotator Cuff Tendinitis. The rotator cuff tendons are impinged due to regular over the shoulder activities of the arm.
The primary goal for treatment that should be kept in mind must be pain reduction and restoration of the shoulder’s functionality. The doctor will also take into consideration the patient’s age, activity level and general health in planning the treatment.
The doctors usually try to start the treatment using Non-Surgical methods before opting for surgical treatment.
Non-Surgical Treatment
The doctors would initially try to treat the Shoulder Impingement syndrome using non-surgical treatment. The recovery time might take several days or week, but the patients will experience a gradual improvement and return of function of the shoulder. The options recommended by the doctors are:
- Rest
The doctor will suggest rest and limiting activities of the arm that include over the shoulder ones too. - Non-Steroidal Anti-Inflammatory Medicines
The doctor might prescribe non-steroidal anti-inflammatory to reduce the pain and swelling. - Physical Therapy
The main focus of a physical therapist will be to restore the normal shoulder motion. They might suggest stretching exercises to improve the range of motion. Sometimes, there might be problem in reaching behind the back; this is caused by the tightness of the inner lining of the shoulder at the back. Specific stretching exercises are recommended to relieve the pain.
Once the pain is relieved, the therapist will recommend exercises to strengthen the rotator cuff muscles. - Steroid Injection
The doctors will go for steroid injections if options like rest, medications and physical therapy do not relieve the pain. This injection includes a local anesthetic and a cortisone (an anti-inflammatory medicine) preparation. The injection is administered into the bursa beneath the acromion to relieve the pain. - Stem Cell Treatment
This involves the extraction of stem cells from an area of higher density and then harvesting them and reinjecting them into the damaged area. The stem cells will transform themselves into the damaged cells and then the healing progresses naturally.
Surgical Treatment
The doctor will recommend surgical treatment when the non-surgical treatment does not suppress the pain and becomes ineffective.
The main purpose of the Arthroscopic Shoulder surgery would be to create more space for the rotator cuff. This is achieved by removing the inflamed portion of the bursa. The doctor might also need to remove a part of the acromion; this procedure is called Anterior Acromioplasty. These procedures are performed through the following techniques:
- Shoulder Arthroscopy
The doctor makes small incisions around the shoulder and performs the procedure using a tiny camera called arthroscope and thin surgical instruments. The doctor will use the arthroscope to guide the instruments and remove the bone and soft tissues and in some cases, the front edge of the acromion and some bursal tissue.
