Shoulder impingement syndrome & acromioclavicular joint arthritis

Treatment options for shoulder impingement syndrome

There are different treatment options available for shoulder impingement syndrome depending on the severity of your case. Whatever condition you present with, our team of shoulder experts will ensure you get rapid diagnosis and specialist treatment to effectively relieve your symptoms.

Conservative treatments for shoulder impingement syndrome

Conservative treatment includes a course of physiotherapy and a programme of home exercises, often combined with one or two subacromial steroid injections performed under ultrasound. While this might be effective in about 65-70% of cases, if symptoms persist more than three to six months, surgical intervention is recommended.

Non-surgical treatment methods

  • Conservative treatments for shoulder impingement syndrome

Surgical treatment methods

  • Arthroscopic subacromial decompression (ASD)

Arthroscopic subacromial decompression (ASD)

The operation is performed by arthroscopy, or “keyhole” surgery, usually through two or three 4mm incisions. An arthroscopy is a minimally invasive procedure that allows the surgeon to access the joint using an arthroscope (tiny camera) and resolve the issue using specially designed surgical instruments. The operation aims to increase the size of the subacromial area and reduce the pressure on the muscle. It involves cutting the coracoacromial ligament and shaving away part of the acromion bone (ASD). This increases the space of the subacromial area and reduces the pressure on the tendon and bursa allowing them to heal.

Pain may arise as well from the small joint between the shoulder blade and the collar bone acromioclavicular (AC) joint due to a cartilage tear, or arthritis with wear and tear. In these cases, a resection arthroplasty of the AC joint is performed, with removal of a few millimetres of bone from each side of the joint.

If a rotator cuff tear is detected during arthroscopy, your surgeon may need to repair this torn tendon. This will involve a different post-operative regime to ASD and if this is the case, you will not be allowed to use your arm or drive for 4-6 weeks.

As with all surgery there is a risk of some complications. These are rare, but you should be aware of them before your operation and your specialist consultant will go through these with you.

Potential complications include:

  • Complications relating to the anaesthetic
  • Infection
  • Failure to achieve a successful result
  • A need to redo the surgery
  • Injury to the nerves or blood vessels around the shoulder Fracture
  • Prolonged stiffness and/or pain