Where in Dubai
Dr. Subhash Ushakoyala, Specialist Orthopaedic Surgeon, sees patients with shoulder impingement at Grand Infinity Medical Center in Al Muteena, Deira, Dubai. Tell the nurse what your work involves, especially lifting or reaching above your head, and which side you sleep on. Bring any shoulder X-ray, ultrasound or MRI you have had, with the written report.
What is shoulder impingement?
Shoulder impingement is pain from the rotator cuff tendons and the bursa above them, a small fluid-filled sac that helps them glide. When you lift your arm, the gap between these tendons and the bony tip of the shoulder (the acromion) narrows. If a tendon is swollen, or a bone spur sits under the acromion, the tissues rub and become irritated. It can follow an injury, overhead sport such as swimming or tennis, repeated lifting, overhead work such as painting or building, or wear with age. The pain is at the top and outside of the shoulder and is often worse at night. Most people get better over weeks to months with rest, exercises and painkillers. Surgery is for pain that does not settle.
Common signs
- Pain at the top and outside of the shoulder.
- Pain that gets worse when you lift your arm, especially above your head.
- Shoulder pain that wakes you at night.
- Pain when throwing, serving or swimming.
- Pain that has lasted several weeks or stops your usual activities.
How Dr. Subhash approaches it
Treatment of shoulder impingement, including keyhole subacromial decompression, is on Dr. Subhash's own list of his shoulder work. He first checks whether the pain comes from impingement, a rotator cuff tear, a stiff (frozen) shoulder or the neck. Most people start with rest from overhead tasks, exercises and painkillers. He explains when an injection into the shoulder may help, and when surgery to make more room for the tendons is worth considering.
What to expect
Consultation
He asks how the pain started, what your work and sport involve, and how you sleep.
Examination and scans
He tests movement and strength. An X-ray may show a bone spur under the acromion. An ultrasound or MRI shows the tendons and bursa.
Simple care first
Avoid the overhead movements that cause pain but keep the shoulder moving. Ice wrapped in a towel and painkillers help. A physiotherapist guides the exercises.
Injection if needed
If rest and exercises do not help on their own, a steroid and local anaesthetic injection into the bursa may ease the pain.
Keyhole surgery if pain continues
In subacromial decompression, inflamed bursa tissue and any bone spur on the front edge of the acromion are removed through small cuts, to give the tendons more room.
Rehabilitation
After surgery the arm is in a sling for a short time, then exercises restore movement and strength.
Getting better
Every patient is different. These are typical milestones, not a promise; your own plan comes from your consultation.
- Most shoulder impingement gets better within a few weeks or months without surgery.
- Stopping all shoulder movement can slow recovery. Gentle movement and exercises help.
- After subacromial decompression the sling usually comes off as soon as comfort allows, so exercises can start.
- Time in the sling and the exercise plan are longer if other repairs were done at the same operation.
When to book a visit
Book a visit if shoulder pain has not gone after a few weeks, or it stops you doing your usual activities. Book sooner if your arm is weak, or you cannot lift it after an injury. Go to emergency care straight away if you have sudden, very bad shoulder pain, the arm or shoulder has changed shape or is badly swollen, or it is hot or cold to touch.
Where to book
Dr. Subhash sees patients at Grand Infinity Medical Center in Al Muteena, Deira, in north-east Dubai. The clinic is at Shop No. 4, next to the Grand Excelsior Hotel.
Grand Infinity Medical Center
Shop No. 4, next to Grand Excelsior Hotel, Al Muteena, Deira, Dubai, United Arab Emirates
DirectionsCall +971 58 599 7460WhatsApp
Questions patients ask
My job involves overhead work. Can I keep working?
Often yes, with changes. Cutting down repeated reaching and lifting above shoulder height helps the tendon settle.
Should I stop moving my shoulder?
No. Avoid the movements that cause pain, such as repeated lifting above your head, but keep the shoulder moving. Stopping completely can stop it getting better.
Will a steroid injection cure it?
An injection into the bursa can ease the pain, which makes the exercises easier to do. It is usually offered when rest and exercises have not helped on their own.
What does subacromial decompression involve?
It is keyhole surgery. Inflamed bursa tissue and any bone spur under the acromion are removed to give the rotator cuff more room. It is sometimes done together with other repairs, such as a rotator cuff repair.
Book an appointment
His nurse answers the phone and WhatsApp.