New perspectives in chronic shoulder pain

Patients with chronic shoulder pain without further specification are currently classified as a subacromial syndrome in its different stages of evolution. This pathology is curable and there is a specific treatment for each stage of the process. The only truly important thing is to know exactly what is causing your shoulder pain and apply the current state of knowledge to treat your ailment.

Many people have had regular shoulder pain that has been treated with infiltrations and recovery sessions, temporarily improving their suffering, but never reaching a specific treatment that definitively frees them from their ailment.

The subacromial syndrome is produced by the suffering of the tendons that wrap the head of the humerus as it passes under the acromion.. This is aggravated either by the activity of the patient, at any time of his life, or by the pointed shape of the acromion, which is the bone that forms the vault of the shoulder and that comes into conflict with these tendons.

Symptomatology

The clinical manifestations of this pathology are pain that extends through the shoulder and sometimes through the lateral face of the humerus, which in more or less intensity, can remain with ups and downs throughout the years as the stages that pass are overcome. from the beginning to the massive break. At the beginning it is about the pain in concrete gestures, when putting on the jacket or when fastening the bra. When lying down the pain increases and the activities carried out with the arms above the head are also affected and, in addition, with the progression of the pathology, strength is lost when working with the arms held high.

The development of chronic painful shoulder

The problem begins with a bursitis that progresses to tendinitis of the supraspinatus and, little by little, to the partial injury of this tendon, then to the rupture of the tendon that, little by little, extends to the neighboring tendons of the infraspinatus and of the subscapular to progress with the years to the massive breakage of all the muscles that form the rotator cuff and subacromial impingement , which is the last chapter of the destruction of the shoulder. The diagnosis is made with Radiological clinic and modern resonances, which allows us to know exactly where we are in evolution.

Treatments

The treatment in the early stages, can be with a good rehabilitation trying to enhance the muscles with ability to lower the humeral head so that the tendon is less. If this fails, we enter the surgical phase. This is always through a minimally invasive arthroscopic technique that allows us to lower the acromion , suture and reinsert the tendons on the humerus with a clinical stay of less than 24 hours.  

In the last phase of subacromial impingement with irreparable injury, depending on the age, infiltrations with platelet growth factors can be a good solution, which in many cases can stabilize the problem and avoid treatment with inverted prosthesis of the shoulder, passing this to be in some occasions, the definitive treatment.