This term covers symptoms involving the tendons and bursa beneath the acromion, the bony roof of the shoulder. It is often called impingement. However, pain cannot always be explained by mechanical narrowing alone; tendon changes and load tolerance also matter.
Sudden shoulder weakness after injury, fever or chest pain radiating into the arm requires prompt or immediate assessment as appropriate.
Causes and risk factors
Repeated overhead work, training changes and age-related tendon changes may contribute. Movement control and strength are also relevant. Several factors may be present at the same time.
Typical symptoms
Pain on the side of the shoulder when lifting the arm and lying on the affected side is typical. Activity above shoulder height can be particularly uncomfortable. Significant new weakness needs separate assessment.
Diagnosis
Examination assesses movement, strength and painful loads. Depending on the findings, imaging is used to assess tendons, the bursa and the joint. Individual tests or X-ray features alone are not enough to decide treatment.
Non-surgical treatment
Graded strengthening, movement exercises and adjusted activity are central. Short-term pain relief may make it easier to start. An injection may be considered for selected symptoms, but does not replace actively rebuilding shoulder function.
Surgical options
Routine enlargement of the space beneath the acromion is not automatically helpful for non-specific subacromial pain. A clear additional injury needs separate assessment. If surgical evaluation is necessary, we refer to specialist shoulder care; we do not currently offer shoulder arthroscopy.
Aftercare and rehabilitation
Return to overhead work and sport is gradual. Exercises should be challenging enough without causing sustained worsening. If symptoms persist, the diagnosis and activity plan are reviewed rather than simply increasing exercise intensity.
Common questions
Is the space beneath the acromion always too narrow?
No. The term impingement does not fully explain the symptoms. Tendon load tolerance and other factors are also important.
Is surgery better than exercises?
For typical subacromial pain, surgery is not automatically superior. Targeted conservative treatment is generally appropriate first.
Arrange a consultation
We discuss which treatment is suitable for your findings and which procedures are available within our outpatient service during a personal consultation. Outpatient operations take place at an external surgical centre.
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Further reading
Selected external resources about this condition. Some linked publications are in German.
Medical background
Sources & further information
These professional and patient resources provide further information about this condition. The text on this page is independently written.
NHS: Shoulder impingementBMJ: Guideline on subacromial decompression