BACKGROUND: Shoulder pain is the third most common musculoskeletal complaint in orthopedic practice. It is usually due to a defect of the rotator cuff and/or an impingement syndrome. METHODS: This review is based on pertinent literature retrieved by a selective search of the Medline database. RESULTS: Patients with shoulder impingement syndrome suffer from painful entrapment of soft tissue whenever they elevate the arm. The pathological mechanism is a structural narrowing in the subacromial space. A multiplicity of potential etiologies makes the diagnosis more difficult; it is established by the history and physical examination and can be confirmed with x-ray, ultra - sonography, and magnetic resonance imaging. The initial treatment is conservative, e.g., with nonsteroidal antiinflammatory drugs, infiltrations, and patient exercises. Conservative treatment yields satisfactory results within 2 years in 60% of cases. If symptoms persist, decompressive surgery is performed as long as the continuity of the rotator cuff is preserved and there is a pathological abnormality of the bursa. The correct etiologic diagnosis and choice of treatment are essential for a good outcome. The formal evidence level regarding the best treatment strategy is low, and it has not yet been determined whether surgical or conservative treatment is better. CONCLUSION: Randomized controlled therapeutic trials are needed so that a standardized treatment regimen can be established.
BACKGROUND: Shoulder pain is the third most common musculoskeletal complaint in orthopedic practice. It is usually due to a defect of the rotator cuff and/or an impingement syndrome. METHODS: This review is based on pertinent literature retrieved by a selective search of the Medline database. RESULTS:Patients with shoulder impingement syndrome suffer from painful entrapment of soft tissue whenever they elevate the arm. The pathological mechanism is a structural narrowing in the subacromial space. A multiplicity of potential etiologies makes the diagnosis more difficult; it is established by the history and physical examination and can be confirmed with x-ray, ultra - sonography, and magnetic resonance imaging. The initial treatment is conservative, e.g., with nonsteroidal antiinflammatory drugs, infiltrations, and patient exercises. Conservative treatment yields satisfactory results within 2 years in 60% of cases. If symptoms persist, decompressive surgery is performed as long as the continuity of the rotator cuff is preserved and there is a pathological abnormality of the bursa. The correct etiologic diagnosis and choice of treatment are essential for a good outcome. The formal evidence level regarding the best treatment strategy is low, and it has not yet been determined whether surgical or conservative treatment is better. CONCLUSION: Randomized controlled therapeutic trials are needed so that a standardized treatment regimen can be established.
Authors: Michelle Petri; Stephen L Hufman; Gregory Waser; Harry Cui; Michael C Snabes; Kenneth M Verburg Journal: J Rheumatol Date: 2004-08 Impact factor: 4.666
Authors: Ruedi Steuri; Martin Sattelmayer; Simone Elsig; Chloé Kolly; Amir Tal; Jan Taeymans; Roger Hilfiker Journal: Br J Sports Med Date: 2017-06-19 Impact factor: 13.800
Authors: Akil Prabhakar; Jeash Narayan Kanthalu Subramanian; P Swathikaa; S I Kumareswaran; K N Subramanian Journal: J Clin Orthop Trauma Date: 2022-02-18