Subacromial Decompression for Shoulder Impingement

What is shoulder impingement?

Shoulder impingement, also called subacromial impingement is a term used to describe several different conditions of the shoulder. Subacromial means “under the acromion” (part of the scapula, or shoulder blade). Characterized by bursitis, inflammation, bone spur formation and sometimes rotator cuff tearing, shoulder subacromial impingement causes pain and limited range of motion. Individuals with subacromial impingement experience acute shoulder pain when raising the arms above the head, reaching into a back pocket or while sleeping on the affected shoulder.

What is subacromial decompression?

Subacromial means “under the acromion”, part of the shoulder blade. Decompression means to reduce pressure. Within the shoulder, tendons provide shoulder stability while the muscles allow the shoulder to rotate. The muscles travel under the part of the scapula called the acromion and then continue on to the humerus (long arm bone). In some patients, the fluid filled sacs that help cushion shoulder movement (called bursa) become inflamed and irritated. Patients in Manhattan, New York City and the surrounding New York boroughs who experience shoulder pain and weakness due bursitis or impingement may be candidates for a special shoulder surgery called subacromial decompression. Dr. Benedict Nwachukwu, orthopedic shoulder surgeon, has extensive experience and success in diagnosing and treating patients with subacromial impingement.

How is subacromial decompression performed?

The goal of subacromial decompression is to increase the size of the subacromial area and to reduce the pressure on the rotator cuff tendon and on the muscle. Dr. Nwachukwu typically performs this surgery on an outpatient basis with regional anesthesia and sedation. He prefers a minimally invasive technique, using an arthroscopic approach that utilizes small incisions in the shoulder and specialized equipment that allow him to operate within the shoulder.

During a subacromial decompression, Dr. Nwachukwu will use an arthroscope to see inside the subacromial space. The rough, irregular, degenerative and inflamed portions of the acromion are identified and removed with small, specialized instruments. If there are bone spurs or if the bursa is inflamed, he will also remove those portions which will allow the muscle to heal and glide smoothly without irritation.

How long does subacromial decompression surgery take?

The time in surgery will depend on the extent of damage. A typical subacromial decompression in an otherwise healthy adult can take as little as 30 minutes. Scaring is minimal, due to the arthroscopic approach and the risk for infection is also minimized. However if the rotator cuff is also torn then it will take longer in order to address any tears identified at the time of surgery.

How long is the recovery after shoulder impingement surgery?

Patients in the New York area who are treated by Dr. Nwachukwu with subacromial decompression can expect to return to their normal daily activities fairly quickly. The shoulder is placed in a sling immediately following surgery, but active movement of the arm and shoulder may begin within 1 to 2 days. Specific shoulder exercises will be provided by Dr. Nwachukwu that will help patients to achieve full range of motion in 2 to 4 weeks. Most patients return to their normal daily activities, work and play in about 3 to 5 months.

For more information on subacromial decompression, or how you can be treated for shoulder pain or shoulder impingement, please contact the office of Benedict Nwachukwu, MD, orthopedic shoulder surgeon serving Manhattan, New York City and surrounding New York boroughs