Subacromial shoulder pain BESS/BOA Patient Care Pathways

Subacromial shoulder pain is commonly located to the top and lateral side of the shoulder. It is exaggerated by overhead activity and can be associated with night pain. It is usually associated with full passive range of movement of the glenohumeral joint. The pain originates from the subacromial space of the shoulder, an area made up of the rotator cuff tendons and the subacromial bursa. This area is separate to the main glenohumeral joint. Pain from this area is mainly caused by rotator cuff tendinopathy, also referred to as ‘shoulder impingement’. Impingement occurs between the undersurface of the acromion (roof of shoulder) and the rotator cuff tendons. These tendons can be either intact or torn. A number of other terms such as supraspinatus tendinopathy, tendinitis and bursitis are also used across different disciplines but the diagnosis is essentially the same and referred to in this document as rotator cuff tendinopathy/impingement.