Bone Spurs
The
acromion is a bone which is on top of the shoulder. The
deltoid muscle is attached to the acromion. A lifetime of
muscle activity of the deltoid can cause the acromion to
develop a hook or a "SPUR". The reason this becomes
problematic is that the rotator cuff lives underneath this
bone and therefore a spur can dig into the rotator cuff.
This is a condition called impingement.
Symptoms
Many people can live their entire life with a bone spur and
never know it. However others can have spurs which can
cause significant shoulder pain. Typically the pain occurs
in the shoulder and travels down the arm. Sometimes the
pain travels (radiates) up into the neck as well.
Treatment Options
Once a bone spur is identified you have several choices.
- Do nothing. If it is not painful this is an excellent choice! Doing nothing is always an option.
- Anti-inflammatory medication / cortisone (steroid) injections: The goal is to reduce your pain. This is typically my first treatment choice. While the steroid injection will not 'cure' the bone spur...it can decrease the inflammation in the shoulder and make it tolerable.
- Physical Therapy: PT can help maximize your strength. Also by working on the scapular muscles, sometimes it can help you reposition the acromion such that it does not impinge on the underlying rotator cuff.
- Arthroscopic Surgery: If other options fail, this typically works well to remove the offending bone spur and give you a pain free shoulder.
Treatment Options: Arthroscopic Surgery
Dr. Brady specializes in arthroscopic shoulder surgery. This means that instead of having to make a large incision around the shoulder to reach inside the shoulder and remove the spur, he performs the entire procedure through small nicks in the skin and uses a camera and small surgical instruments to repair everything in the shoulder. Since the camera is extremely small he can position the camera ANYWHERE in the shoulder and see things much better this way.
The primary goal of surgical treatment is pain relief and it is quite effective. Over 90% of patients experience substantial or total pain relief. Dr. Brady typically recommends surgery if nonoperative treatment does not relieve your symptoms.
In the operating room, Dr. Brady will also examine the entirety of your shoulder. If other pathology is encountered such as a rotator cuff tear...it will be addressed at the same time.