Subacromial Pain Syndrome

Subacromial pain at work? 

Subacromial pain, also known as rotator cuff related shoulder pain, is a common occupational health condition affecting structures which lie in-between the acromion and the humeral head (the subacromial space), such as the subacromial bursa and rotator cuff tendons. Subacromial pain presents as pain and tenderness in the shoulder, sometimes referring to the upper arm. It can be aggravated by reaching overhead or repetitive overhead activities, reaching behind your back and sleeping on the affected side. These movements are often associated with manual activities in the workplace so if you are suffering from subacromial pain at work you may need to seek help.

Pain in this area is commonly caused by rotator cuff tendinopathy, predominantly affecting the supraspinatus tendon. The rotator cuff muscles are a group of muscles that sit in and around the shoulder blade and provide strength and stability for shoulder function. As well as pain, you may notice some weakness in your shoulder, and your shoulder movement may be reduced due to pain.

What causes subacromial pain? 

Subacromial pain is multifactorial and can be affected by many health and wellbeing factors such as anatomy, muscle imbalances, static postures, mental health and increased age. It commonly affects individuals who participate in repetitive overhead activities, as this can lead to progressive overload of the supraspinatus tendon.

When this happens, the tendon has exceeded its load tolerance capacity, and is unable to cope with the demands of the activity, therefore causing pain. If the amount of load placed on the tendon isn’t managed appropriately, it can become chronic through continued overloading of the tendon.

What can I do?

If you have been affected by subacromial pain at work it can be treated conservatively with physiotherapy treatment and advice, however, your attitude and the actions you take are the most important factors in preventing long-term problems. The most effective way to manage symptoms of subacromial pain are to

  1. Identify what factors may be contributing to your pain (eg slumped postures, repeated overhead activity, smoking and stress) and modifying your activity to try to minimise these factors.
  2. Talk to your GP or pharmacist about what pain relief or anti-inflammatory medication may be right for you. If your pain is controlled, you will be able to maintain more movement, while anti-inflammatory medication such as ibuprofen would help to reduce any inflammation present.
  3. Apply an ice pack (wrapped in a towel) to reduce pain and inflammation.
  4. Report any issues to your line manager immediately so they can make any necessary work-related changes.

How can physiotherapy help? 

At Physiotherapy Matters, our physiotherapists can conduct a thorough assessment to confirm the diagnosis and work with you to help you manage pain and return to normal activity by

  1. Helping you understand your condition
  2. Helping identify the factors that may be aggravating your symptoms
  3. Providing advice on how to minimise your aggravating factors
  4. Completing ergonomic workplace assessments to minimise any work-related risk
  5. Develop symptom management strategies so you always feel in control
  6. Provide an individualised exercise program to strengthen to the rotator cuff muscles and tendons
  7. Provide additional manual therapies that may help ease symptoms, such as
    1. Taping to improve postural awareness and reduce the amount of load/compression on the tendon and therefore relieve pain.
    2. Soft tissue massage to reduce any muscular tension in the surrounding muscles
    3. Mobilisation of the upper back to reduce any stiffness that may be causing altered posture and movement patterns at the shoulder causing increased compression on the tendon.
    4. Acupuncture for reduction of pain and inflammation
  8. Refer for additional services if required including
    1. Shockwave therapy to improve the healing processes
    2. Corticosteroid injection – to reduce pain and allow exercise management

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