Subacromial Bursitis and Shoulder Impingement

What is it : This is a very common shoulder problem and the main complaint is that the shoulder hurts when trying to lift it away from the side of your body. It may also hurt when you sleep on that shoulder. Shoulder bursitis can be caused by a wide range of issues which could be affecting your neck, elbow or any other part of your arm. Sometimes it may have started after a minor injury to the shoulder, other times it can just gradually worsen without any injury. Shoulder impingement can happen because of a bone spur on the acromion (part of the shoulder). When you move your arm up or to your side, the spur hits the other bones and can cause pain.

Management : The majority of shoulder bursitis or impingement can be treated without an operation. Physiotherapy for the shoulder and neck should be attempted first. Simple pain relief such as paracetamol and anti-inflammatory medication can be tried. Cortisone (steroid) injection can help with reducing the inflammation in the shoulder which can improve the bursitis type pain. This can be attempted up to 3 times but we do not recommend more than that. The operation for subacromial bursitis or shoulder impingement is a shoulder arthroscopy (key hole) where the bursa can be cleaned out and any spurs on the acromion can be removed. This is called an arthroscopic subacromial decompression or ASAD.

Post-operative : After an arthroscopic subacromial decompression for subacromial bursitis or shoulder impingement you will be placed in a sling for comfort. You are allowed to come out of the sling and start moving your shoulder as pain allows. Once you are comfortable you can remove the sling permanently. It may take you several months to regain your range of movement in that shoulder.