Patients with chronic shoulder pain without further specification are currently categorized as a subacromial syndrome in its different evolutionary stages. This pathology is curable and there is a specific treatment for each stage of the process. The only really important thing is to know exactly what is causing your shoulder pain and apply the current state of knowledge to treat your condition.
Many people have had regular shoulder pain that has been treated with infiltrations and recovery sessions, temporarily improving their suffering, but never reaching a specific treatment that will free them from their pain for good.
Subacromial syndrome is caused by pain in the tendons that wrap around the head of the humerus as it passes under the acromion. This is aggravated either by the patient’s activity, at any time in his life, or by the pointed shape of the acromion, which is the bone that forms the shoulder vault and conflicts with these tendons.
Symptomatology
The clinical manifestations of this pathology are pain extending over the shoulder and sometimes over the lateral aspect of the humerus, which in more or less intensity, can remain with ups and downs over the years as the stages from the beginning to the massive rupture are overcome. At the beginning it is pain in specific gestures, when putting on a jacket or fastening a bra. When lying down the pain increases and activities performed with the arms above the head are also affected and, in addition, with the progression of the pathology, strength is lost when working with the arms raised.
The development of chronic painful shoulder
The problem begins with bursitis that progresses to supraspinatus tendinitis and, little by little, to partial injury of this tendon, then to tendon rupture that, little by little, extends to the neighboring infraspinatus and subscapularis tendons until advancing over the years to massive rupture of all the muscles that form the rotator cuff and subacromial impingement, which is the last chapter of the destruction of the shoulder. The diagnosis is made with clinical radiology and modern resonance imaging, which allows us to know exactly where we are in the evolution.
Treatments
The treatment in the first phases, can be with a good rehabilitation trying to strengthen the muscles with capacity to make descend the humeral head so that the tendon shears less. If this fails, we enter the surgical phase. This is always by means of a minimally invasive arthroscopic technique that allows us to reduce the acromion, suture and reinsert the tendons on the humerus with a stay in the clinic of less than 24 hours.
In the last phase of subacromial impingement with irreparable injury, depending on age, infiltrations with platelet growth factors can be a good solution, which in many cases can stabilize the problem and avoid treatment with an inverted shoulder prosthesis, which in some cases becomes the definitive treatment.