The rotator cuff consists of four tendons that arise from muscles attached to the scapula (shoulder blade). The function of the cuff is to allow shoulder movement. The tendon runs beneath an arch made up of bone and a ligament. This is called the subacromial arch.
Spurs of bone may develop over time on the front corner of this bone called the acromion and cause abrasion of the tendon and its surface covering called the bursa. This can produce pain when raising the arm and is a condition called subacromial impingement.
Symptoms of Subacromial impingement
The pain often is felt over the cape of the shoulder and upper arm and may be particularly noticeable at night. Certain movements, such as reaching up to a high shelf or putting the affected arm into the sleeve of a garment, are painful.
Treatment of Subacromial impingement
Pain killers and anti-inflammatory medication may help reduce pain. Physiotherapy can help to strengthen the rotator cuff muscles and improve symptoms. A steroid injection on to the surface of the tendon can help reduce inflammation.
Surgery may be necessary if all other measures fail. A keyhole (arthroscopic) operation can be performed to remove the bone spurs and inflamed bursa and to divide the ligament over the tendon. This is called a subacromial decompression.