Impingement describes a condition of abrasion of the deep muscles and tendons of the shoulder (rotator cuff muscles) on the undersurface of the shoulder blade (acromion). It is an extremely common problem in the 30-60 year old age group.
It usually presents with pain in the upper arm/shoulder, significant at night, and when using the arm in the upper arcs of movement. Usually a full range of movement is maintained.
Treatment is usually non surgical to start with, with the majority of patients responding to a combination of time, tablets, physiotherapy and injections into the subacromial space of the shoulder. For patients with Calcific tendonitis we now have access to Extra Corporeal Shock wave Therapy as per the NICE guidelines.
For those paients with ongoing pain despite these treatments a keyhole operation (Arthroscopic subacromial decompression or ASD) has proven successful in resolving symptoms. This procedure involves a diagnostic view around the shoulder joint and removal of a spur of bone on the undersurface of the shoulder blade (the subacromial space) to resolve the abrasion pain symptoms. The operation is relatively minor and can often be done as a day case. There are no slings or stitches in the post operative period.