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Orthopaedic Surgery

Contact

Spire Yale (Private Only)
Anna Gizzi
01978 268 065

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Robert Jones and Agnes Hunt Orthopaedic Hospital (RJAH), Oswestry (private and nhs)
Hayley Higgins
01691 404 099

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Wrexham maelor (NHS Only)
Anne fisher
01978 725720

Shoulder Pain

Impingement syndrome, also called painful arc syndrome occurs when the tendons of the rotator cuff muscles become irritated and inflamed as they pass through the subacromial space. This can result in pain, weakness and loss of movement at the shoulder. The pain is often worsened by overhead movement and may occur at night.

Impingement syndrome can usually be diagnosed by history and physical examination. Plain x-rays of the shoulder can be used to detect some joint pathology including acromioclavicular arthritis, variations in the shape of the acromion, and calcification of the supraspinatus tendon. MRI scan or ultrasound may be needed to exclude other pathology including rotator cuff tears.

Treatment

Conservative treatment includes rest, cessation of painful activity, and physiotherapy focused at maintaining range of movement and rehabilitating the periscapular "core" muscles. Corticosteroid and local anaesthetic injections should be performed prior to surgery as temporary but sometimes permanent relief of symptoms are achieved.

Surgery may be done arthroscopically. The subacromial space may be widened by resection of the anterior 8-10 mm of the acromion and sometimes the end of the clavicle, along with excision of osteophytes on the under-surface of the acromioclavicular joint.

Other soft tissue conditions causing pain include subscapularis tendinopathy and biceps tendonitis. Treatment again relies upon correct diagnosis, physiotherapy, injection therapy and finally surgery.