What is shoulder impingement?
Shoulder impingement is a common type of shoulder pain. A group of muscles called the ‘rotator cuff’ surround and support your shoulder. These help you to lift your arm up so you can reach for things above you. The tendons for these muscles lie in a narrow space between the top of your arm bone and the bone at the top of your shoulder blade.
Shoulder impingement happens if lifting your arm puts too much pressure on the tendons. When the tendons press against the shoulder blade above them, this causes pain. You may also find it harder to move your arm.
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Symptoms of shoulder impingement
Shoulder impingement may start suddenly or come on gradually.
Your symptoms may include:
- Pain in the top and outer side of your shoulder
- Weakness in your arm
- Pain that’s worse when you lift your arm, particularly when lifting it above your head
- Pain or aching at night, which can affect your sleep.
Your shoulder will not normally be stiff if you are experiencing shoulder impingement. If it is, you might have a frozen shoulder.
Causes of shoulder impingement
The potential causes of shoulder impingement include:
- your tendons getting swollen or torn from overuse (if you’re doing a lot of sports) or ‘wear and tear’ as you get older
- the shape of the bone at the top of your shoulder blade (your acromion), which rubs against your tendons
- getting bony growths (spurs) on your acromion as you get older
What is shoulder decompression surgery?
Shoulder decompression is an operation on your shoulder to treat a condition called shoulder impingement, which causes pain when you lift your arm. The surgery involves removing inflammation around the muscles that move the shoulder and to remove spurs of bone (this is bony growth which has formed on normal bone).
It’s usually carried out through keyhole surgery (arthroscopy).
What are the alternatives to subacromial decompression?
Shoulder impingement symptoms can often be eased with:
- Self-help treatment, including rest and avoiding painful movements
- Over the counter painkillers and anti-inflammatories
- Physiotherapy
- Steroid injections.
Your surgeon will usually only recommend you have subacromial decompression if other treatments haven’t worked.
What happens during shoulder decompression surgery?
This type of surgery is performed using keyhole surgery techniques. This means your surgeon will insert a camera into your shoulder to examine the shoulder blade. Surgical instruments will then be inserted into your shoulder through small incisions. The number of incisions depends on the techniques your surgeon uses. Your surgeon will aim to make more space under your acromion (the bony tip of the outer edge of your shoulder blade) so it doesn’t press against your tendons. To do this, they’ll take away some of the bone and tissue.
Preparing for your shoulder decompression surgery
After your surgery, you’ll have time to recover and your arm will likely be placed in a sling. Your surgeon will explain how long you should use the sling for and how to look after your wound.
If an arthroscopy was used to perform your shoulder surgery, you should be able to return home the same day. You might experience some discomfort following your surgery, but this can typically be handled with over-the-counter pain killers.
What happens after shoulder impingement surgery?
After your surgery, you’ll have time to recover and your arm will likely be placed in a sling. Your surgeon will explain how long you should use the sling for and how to look after your wound.
If an arthroscopy was used to perform your shoulder surgery, you should be able to return home the same day. You might experience some discomfort following your surgery, but this can typically be handled with over-the-counter pain killers.
Recovering from your surgery
Before you go home, you will likely meet with a physiotherapist who will support your recovery with exercises you can complete at home. It usually takes three to six months to fully recover from a subacromial decompression procedure. However, everyone is different.
You’ll likely need help to wash and dress yourself at first. This should get easier after a few weeks.
Complications and side effects of shoulder impingement surgery
As with any surgery, there are potential risks that are associated with having shoulder surgery. These include:
- Infection, however this can be treated with antibiotics
- Blood clots: You will be asked to move around as much as possible to promote healthy blood flow and prevent clots
- Swelling and bruising around your wound, though this will resolve itself in time
- Scarring at the site of the incisions. However, this should fade in time.