Diagnosis and treatment of subacromial pain syndrome
Based on extensive research in the literature available on this topic, this guideline recommends the use of multiple tests to establish the diagnosis of subacromial pain syndrome (SAPS); especially the Hawkins-Kennedy, painful arc, drop arm, infraspinatus strength and supraspinatus strength.
In the acute phase of SAPS, NSAIDs may be useful in alleviating pain, but for no longer than two weeks. Exercises should be of low intensity but high frequency and aimed at stabilizing the scapula and if necessary postural correction/ adjustment. In case of persisting symptoms, subacromial corticosteroid injections may be an effective intervention, or ultrasound can be used to rule out rotator cuff tears – if the ultrasound examination is inconclusive or in order to measure the size in the case of tissue lesions, other imaging modalities such as MRI can be considered.
Surgical treatment should only be considered if comprehensive non-operative treatment does not lead to sufficient improvements. The indication for a rotator cuff repair depends on the size of the defect, condition of the tissues involved and patient characteristics.
> From: Diercks et al., Acta Orthop 85 (2014) 314-322. All rights reserved to The Author(s). Click here for the Pubmed summary.