Subbar tightness syndrome generally begins with conservative treatment consisting of: rest, reduction of pain and swelling in the shoulder joint, and limitation of physical activity. It may take about a year to notice a clear improvement. During this period, to reduce shoulder pain, your doctor may prescribe anti-inflammatory drugs such as Olfen or diclofenac, or give you an injection of a glucocorticoid (diprospan).
The injection has anti-inflammatory and analgesic effects, but often temporary. The basis of conservative treatment is exercise-based physiotherapy. Movement therapy should focus on strengthening the rotator cuff and the muscles that stabilize the scapula. A good shoulder and shoulder posture increases the gap where the tendon and caliper are located and reduces compression.
When conservative treatment does not bring the desired results, and shoulder pain is still felt, the orthopedist may suggest surgery. Several surgical techniques are available, which are used depending on the nature and severity of the injury. Most often, in the surgical treatment of subbar syndrome, arthroscopy of the shoulder joint is used, which consists in decompression of the subbar space by arthroscopic excision of the inflamed subbar calcaneus, and sometimes acromioplasty, i.e. cutting and sawing of the shoulder appendix. In case of partial or complete rupture of the rotator cuff, arthroscopic repair of the damaged tendon of the rotator cuff muscle using bone anchors is performed.
In case of massive damage to the rotator cuff, there are several different methods of surgical treatment. One of them is the reconstruction of the upper articular bag, sewing a “patch” into the pelvis and into the head of the humerus holding it up. Another method is partial repair of damaged tendons or the implementation of a special balloon into the subbar space, expanding it and improving the biomechanical working conditions of the shoulder. The final solution is the use of a special so-called inverted endoprosthesis of the shoulder joint.