What is it?
Impingement of the shoulder is very common and affects a wide variety of people.
Impingement is not a diagnosis per se, but represents a syndrome of pain and dysfunction of the shoulder caused by the contents of the shoulder 'catching’ on the bones when the shoulder is moved. The symptoms are often worse when using the arm in an elevated position or at night, where the pain can disrupt your sleep.
The most common causes include bursitis (inflammation/thickening of the lubrication pads within the shoulder) bony spurs and rotator cuff tendon wear and tear, although other conditions can also present with impingement.
Establishing the cause is the first step, and this can often be done by evaluation in the clinic alone together with simple investigations, such as x-rays. Sometimes it is necessary to ‘scan’ the shoulder, either using an MRI or Ultrasound scan to confirm the cause, but more importantly to help plan for treatment.
Avoiding exacerbating activities and improving your posture can have dramatic effects on reducing symptoms. However a formalized physiotherapy programme facilitated by a cortisone injection into the shoulder, may be required and can be enough to resolve the situation.
If non-surgical methods have been tried and have not proved successful, keyhole surgery can be undertaken. The surgery is performed as a day case and is done through 2-3 very small incisions in the shoulder, that don’t even require stitches.
The aim of the surgery is to deal with the cause of the ‘catching’ in the shoulder and to make more space, by releasing soft tissue and removing a very small amount of bone.
You will require a sling to rest the shoulder for a few days, but you are encouraged to get your shoulder moving as soon as possible after that. Most patents will undergo post-operative rehabilitation under the direction of a physiotherapist.
For some it takes several months to notice improvement, but overall the vast majority of patients who undergo this procedure have a significant improvement if not a cure in their symptoms.