Shoulder bursitis tendonitis treatment
Non-surgical treatment of bursitis, tendinitis and impingement syndrome
Initial episodes of bursitis or “tendinitis” can be treated nonsurgically: rest, ice, oral anti-inflammatories, physiotherapy, etc. Yet the most appropriate treatment is to simply avoid activities that cause impingement.
Cortisone injections are effective in the short term but should ideally be given after imaging of the bony structures (to rule out the possibility of a tumour) and soft tissues (ultrasound or MRI to rule out a diagnosis of rotator cuff tears).
If there is calcium build-up in the bursa or cuff, needle aspiration can be attempted (in radiology under fluoroscopy or ultrasound guidance). I do perform such technique at my office, using ultrasound guidance. Success rate is close to 75-80 %.
Shock wave therapy can also be helpful for some type of calcific deposits, but is often poorly tolerated.
If symptoms do not improve after several weeks of conservative treatment, a more in-depth investigation should be carried out and other problems considered, such as adhesive capsulitis (characterized by a loss of movement), osteoarthritis, arthritis or neoplasias.
The goal is to increase the space between the rotator cuff and the overlying bony structures by removing the coraco-acromial ligament and a layer of bone a few millimetres thick to allow the elevation, rotation and abduction of the arm without tendon-bone contact.
I prefer to perform this surgery with the patient awake, under local or regional anaesthetic, in a semi-seated position.
The arthroscope (camera) is inserted through a minor incision behind the shoulder and the shoulder is filled with water.
Through another tiny lateral incision, I insert instruments to aspirate the debris, make an incision in the tissues and trim the underside of the acromion bone. The entire procedure takes about 30 minutes.
About an hour later, the patient is allowed to leave with the person who is accompanying him. Before leaving, he will be given an information kit and a prescription for pain medication.
A sling is prescribed (airplane type) after surgery for comfort, but it can be taken off for early mobilization and common use of the hand (writing, eating, driving, etc).
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Five months after my operation, despite the severity of my wound, I am again able to ride a bike without difficulty or pain. I had an impeccable and attentive follow-up from Dr. Beauchamp. Thank you!