Shoulder Bone Spurs

Impingement and Subacromial Decompression

Bone Spur Before Shaving
Bone Spur Before Shaving photos

Bone Spur Before Shaving

Impingement refers to the pathological contact between the acromion bone and the rotator cuff. There are many underlying causes of impingement. Most commonly, a bone spur under the acromion reduces the space available for the rotator cuff to travel back and forth. This space becomes even more compromised once the arm is elevated at or above shoulder level.

The bursa (small fluid sac) between the bone and rotator cuff becomes inflamed and painful. The symptoms of impingement include pain in front and outside portion of the shoulder when a person performs activities at or above the shoulder level. This is sometimes accompanied with weakness and radiating pain down to the mid arm area or up to the neck muscles. MRI is helpful in identifying inflammation within the bursa and identifying any other concomitant injuries.

Treatment is initially aimed at reducing inflammation and pain (oral anti-inflammatory medication or injection) followed by regaining the motion and strength via physical therapy. If this treatment fails to resolve the pain within 3-6 months, then arthroscopic surgery is indicated. The surgery involves placing a small camera (4 mm or one sixth of an inch) inside the shoulder joint to evaluate all of the structures within the joint. Most pathological conditions within the joint can be fixed with arthroscopic techniques. Subsequently, the camera is placed inside the inflamed bursa, and both the bursa and the bone spur are resected using arthroscopic instruments (subacromial decompression). This technique avoids any damage to the deltoid muscle, which is extremely important for strength, function, and stability of the shoulder joint. With adequate rehabilitation and physical therapy, most patient return to good functional status within three months.