Subacromial pain syndrome

Subacromial pain syndrome is a general term for pain that starts in the shoulder and can spread towards the neck or down the arm. It's the most common reason for shoulder pain.

The shoulder is the most mobile joint in the body. It's a ball and socket joint, and it allows a very wide range of movement, supported by the rotator cuff muscles and tendons. With subacromial pain syndrome, these tendons are often weakened.

The condition can develop because of:

• age related changes
• repetitive strain
• injury or trauma

Sometimes, though, it appears without any apparent reason.

Other factors that can affect the health of your tendons include:

• smoking
• obesity
• high fat diet
• high cholesterol levels
• diabetes (Type 1 and 2)

The main symptom of subacromial pain syndrome is pain in the upper arm, brought on by certain movements or activities. Usually these are things that mean lifting your arm above shoulder level, or reaching behind your back, such as when you put on a jacket.

You may also find it hard to lie on the affected shoulder, and this can disturb your sleep.

To diagnose subacromial pain syndrome, you'll need to be assessed by a doctor. The doctor will start by asking you about your shoulder problem, and then examine the shoulder. This may include checking how far you can move it and how strong it is.

Sometimes you may need a further examination, so that other possible health conditions can be ruled out.

Treatment for subacromial pain syndrome depends on how severe your symptoms are. Most cases get better on their own, though some take a while to settle.

Your arm may feel really painful, but it's important to keep your shoulder moving. To help with the pain, break the activities you normally do into smaller amounts.

These are short term measures to ease the pain. As soon as you're able, try to get back to your normal activities, because this is the best way to help your recovery.

Targeted shoulder exercises can help with subacromial pain syndrome. Exercises that encourage movement, along with stretching and strengthening, can improve how well you move your arm and ease your pain.

Read about exercises for shoulder problems

Pain medicine can help you move more comfortably, and that in turn can help your recovery with subacromial pain syndrome.

Corticosteroid injections

If painkillers aren't controlling the pain, your doctor may talk to you about having a corticosteroid injection into your shoulder joint.

Corticosteroids are medicines that help reduce pain and inflammation. They may also be given together with a local anaesthetic.

Injections won't cure your condition or reduce shoulder stiffness. They are used to help with the pain.

Subacromial pain syndrome can sometimes mean you need to take some time off work so that you can recover. How long you're off will depend on your condition and the kind of work you do.

You don't need to be free of symptoms before you think about going back to work. Carrying on at work, or going back as soon as you're able to, will help your recovery.

Getting back to your normal daily activities bit by bit can help build up your strength and stamina.

If you follow this advice, you should see gradual improvement over time.

Talk to a doctor if:

• your symptoms haven't improved within 6 weeks of following this advice
• your symptoms get worse

Find out how to reach MSK services in your area.

With any health condition, it's also important to look after your mental wellbeing, because it can affect your recovery.

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