Subacromial Impingement

Here are some facts & things you need to know

What is impingement?

As seen in the above picture, the shoulder has a small space called the subacromial space (marked by an arrow). The most important tendon of the shoulder called the rotator cuff travels in this space. Sometimes due to arthritis or repeated trauma, this space becomes narrow because of overgrowth of bone. In such a situation, when one tries to lift the arm, the rotator cuff rubs against this extra piece of bone causing pain. Left untreated the rotator cuff can actually get torn as a result of continued friction & can cause inability to lift the arm.

An injection of steroid into the joint is a perfectly safe treatment in such instances. Coupled with physiotherapy, steroid injections help in decreasing the pain, swelling & in?ammation associated with this condition

Caring for the shoulder after the injection.

Steroid injections into the shoulder are given under local anesthesia. If you are a diabetic, blood sugar levels need to be well controlled (fasting sugar < 150) on the day of the injection.

You needn’t be fasting for the injection. It is advisable to eat light food on that day. Though after the injection you may experience a temporary increase in pain, this is well controlled with rest, ice packs & simple pain relief tablets.

The beneficial effects of the injection are palpable from the third day onward & last for a varying time period ranging from 1-3 months.

Physiotherapy is essential.

In the long run, the one treatment that will give lasting relief is physiotherapy. It can be easily done at home using a home physiotherapy kit or can be done in a hospital under the supervision of a physiotherapist. The exercises consists of a special type of strengthening program that tones up the shoulder musculature & relieves pain.

In the initial few days of physiotherapy, you might feel more pain. It is easily controlled with hot packs & painkiller tablets, but as you get into the ?ow, the pain levels steadily decline & you will no longer need pills Progress can be a bit slow with recovery coming over 3-6 months. Patience & perseverance will pay dividends in the long run.