Subacromial pain syndrome is a generic term that describes pain associated with any of the structures that sit within the space between the ball and socket joint of the shoulder (subacromial space).
This includes conditions such as subacromial bursitis, rotator cuff tears, rotator cuff or bicep tendon problems and calcific tendons.
The level of pain associated with the condition can vary from person to person with some people reporting a pinch or catch of pain that occurs with certain movements and others reporting a more severe ache that can cause sleep disturbance and affect normal activities.
This type of shoulder pain can affect both shoulders but it is more usual to only have it on one side. The main symptoms of subacromial pain syndrome include:
- An ache or sharp pain in the shoulder or upper arm that is often worse during shoulder elevation such as lifting activities
- A 'painful arc' where pain is produced at certain angles of shoulder movement
- A feeling of Stiffness or weakness when using the arm
- Discomfort lying on the painful side that could affect ability to sleep
What causes subacromial pain syndrome?
Anyone can develop symptoms of subacromial pain syndrome and many factors can contribute towards its development. These include:
- Muscle weakness or imbalance
- Shoulder stiffness
- Posture
- Age related change of the muscles/ tendons or joints of the shoulder
Symptoms can develop gradually or follow from an injury, and are more commonly experienced in individuals older than 45 years of age.
How is it diagnosed?
Diagnosis is usually made from the patient’s history and a simple examination, without the need for special investigations.
An X-ray or ultrasound scan may be performed if there is uncertainty about the diagnosis or if symptoms fail to settle with a course of Physiotherapy.
There is self-management advice provided below to help minimise symptoms and facilitiate the healing process:
Pain relief
Painkillers such as paracetamol and ibuprofen or anti-inflammatory gels may be helpful to control the pain and allow you to continue exercising. Discuss this with your GP or pharmacist. A steroid injection may be offered if pain is a significant problem, enabling you to exercise the arm.
Exercise
The research into subacromial pain syndrome consistently shows that strengthening and stretching exercises are the most important thing that you can do to ease symptoms and stop it recurring.
Exercise should focus on muscle strengthening around the shoulder and general awareness of your overall posture is important.
Activity modification can also help. This simply means trying to keep the shoulder moving within the limits of your pain.
Further management options
If there is no response to the self-management information given within four to six weeks, please seek further advice from your physiotherapist or GP.