Subacromial pain syndrome

The main symptom of subacromial pain syndrome is chronic shoulder pain. Pain varies between individuals, with some people complaining of sharp pain and catching or pinching during certain movements, while others experience a constant dull ache.

Common symptoms of subacromial pain syndrome include:

• Pain at the front and side of the shoulder which may radiate along the upper arm to the elbow
• Pain may be worse during certain movements such as raising the arm above the head, moving the arm behind the back, or across the body
• Stiffness of the shoulder joint
• Reduced range of movement
• Weakness or pain when lifting the arm
• Pain or discomfort when lying on the affected side

Subacromial pain syndrome may be caused by several factors including:

• Age-related degeneration of the muscles and tendons of the shoulder joint
• Poor posture
• Previous shoulder injury
• Overuse of the shoulder joint during certain activities like sport
• Bursitis (inflammation of the fluid-filled sacs) in the shoulder joint
• The natural shape of your acromion being curved or hooked rather than flat
• Growths of bone (bone spurs) developing on the acromion as you age

Surgery may be an option if your symptoms don't improve after six to twelve weeks of non-surgical treatments.

Activity modification

The first step in the treatment of subacromial pain syndrome is normally to reduce or stop the activity that led to the development of pain. This is important in the initial stages of the condition to prevent worsening and to give your shoulder time to heal.

Exercises

Regular shoulder exercises are the most effective way of managing subacromial pain syndrome. They work by strengthening the muscles in your shoulder joint and increasing flexibility and range of motion. Our expert team of physiotherapists can show you some suitable exercises.

Painkillers

Painkillers such as paracetamol and non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen and naproxen can help relieve pain and inflammation. They are especially useful if pain is making it difficult for you to exercise. Your consultant, GP or pharmacist can recommend a suitable painkiller.

Steroid injections

If painkillers and exercise aren't effective, a corticosteroid injection into the joint can provide short-term pain relief. If your pain is so severe that you are unable to practice regular exercises, a steroid injection may be necessary before starting an exercise programme or physiotherapy. It's important to continue your shoulder exercises after your steroid injection or the pain is likely to come back once the effect of the injection has worn off.

Shoulder surgery

If non-surgical treatments have not been effective in relieving subacromial pain syndrome, your consultant may consider surgery.

Subacromial pain syndrome is usually treated with a procedure called subacromial decompression surgery (acromioplasty). This is a type of laparoscopic (keyhole) surgery that involves removing some bone and tissue from the subacromial space to widen the space, ease movement and reduce pain. The operation is performed using a camera and instruments inserted through small incisions in the skin. It is usually done as a day-case meaning you can normally go home the same day.

Your consultant will ask you some questions about your symptoms such as when they started, and whether they get worse with certain movements or activities. Your consultant will perform a physical examination of your shoulder to check your muscle strength, flexibility, and range of motion.

Scans such as X-rays are not normally needed to make a diagnosis, but your consultant may request an X-ray if they suspect another cause for your pain, or before giving a steroid injection.

Your first appointment with Circle Health Group is very important, as it's where we get to know you and discuss your concerns and expectations for treatment. It's important to us that you are as comfortable and well-informed about your diagnosis and treatment as possible, so please ask your consultant any questions you may have.

At the end of your appointment, your consultant will make a diagnosis based on your symptoms, history, and physical examination. They will then discuss possible treatments with you and decide on the best option for you going forward.

How long does pain last after subacromial decompression surgery?

After shoulder decompression surgery, it's normal to have some post-operative pain. This can last from a few weeks to several months. Painkillers, non-steroidal anti-inflammatory drugs and applying ice packs regularly will help to relieve pain and swelling.

How long does subacromial decompression surgery take?

Subacromial decompression surgery normally takes around one hour.

How long does it take to recover from long does subacromial decompression surgery?

It normally takes around four months to fully recover from subacromial decompression surgery.

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If you would like to see a consultant or learn more about treatment for subacromial pain syndrome, book your appointment online today or call a member of our team directly on 0141 300 5009.

Content reviewed by Circle in-house team in March 2023. Next review due March 2026.

1. Subacromial pain syndrome,  NHS Mersey Care NHS Foundation Trust
2. Guideline for diagnosis and treatment of subacromial pain syndrome, PubMed
3. Shoulder impingement, NHS
4. Shoulder Decompression Surgery Orthopaedic Specialists