Influence of Operative and Conservative Therapy on the Ability to Work of Patients With Subacromial Impingement: A Prospective Clinical Comparative Study

Background Subacromial impingement is a common reason for pain in the shoulder. Treatment is difficult and patients are not able to work for a long time. An increasing number of operative treatments can be observed although conservative treatment is effective, too. There is no study that observed how operative and conservative treatment influence ability to work. Methods 86 persons were included in this prospective study. Surgery was performed with an arthroscopy of the shoulder. Conservative treatment was carried out by a physiotherapist under control of the physician. Reevaluation was conducted 3 and 6 months after the initial contact. Here we observed the time the participant was not able to work, Constant Score and pain on the numeric rating scale. Results Both therapies were able to improve pain and function. During conservative treatment, improvement was faster than under operative care. Time without ability to work was 7 +/- 5 weeks longer after operative treatment than under conservative therapy (p < 0.001). No relevant influence of acromioclavicular joint arthrosis could be observed. Bursitis subacromialis detected in the MRI was a predictor of faster recovery. Conclusion Conservative and operative treatment improved pain and function significantly. Properly carried out conservative therapy enables patients to get back to work earlier.