Subacromial Pain Syndrome


Non-traumatic, one-sided shoulder pain at or around the acromion (bony bump on top of shoulder) that is often worst during or after lifting your arm.

    Treatment Options
  • Rotator cuff and scapular muscle strengthening
  • Stretching
  • Posture corrections
  • Movement re-education, especially with overhead reaching
  • Manual trigger point release or trigger point dry needling
  • Heat, ice, low level laser, and NSAIDs for pain-relief
exercise1 exercise2 exercise3

Diercks, Ron et al. “Guideline for Diagnosis and Treatment of Subacromial Pain Syndrome: A Multidisciplinary Review by the Dutch Orthopaedic Association.” Acta Orthopaedica 85.3 (2014): 314–322. PMC. Web. 8 Sept. 2018

José L Arias-Buría, Carlos Martín-Saborido, Joshua Cleland, Shane L Koppenhaver, Gustavo Plaza-Manzano, César Fernández-de-las-Peñas; Cost-effectiveness Evaluation of the Inclusion of Dry Needling into an Exercise Program for Subacromial Pain Syndrome: Evidence from a Randomized Clinical Trial, Pain Medicine, , pny021,


Working with poor posture increases risk
Immobilization is not recommended
MRI’s are not recommended unless conservative treatment fails
Dry needling helps improve quality of life and decrease overall cost
Surgical treatment is not more effective than physical therapy


Trying Physical Therapy First For Low Back Pain May Curb Use Of Opioids ...and save money

Recently, NPR featured an article about how trying physical therapy first for low back pain may curb use of opioids and save health care dollars. You can read/listen here.

This study determined that seeing a physical therapist first for your back pain may curb use of opioids and save money as well. It’s something physical therapists have known for a long time. Here are some common questions we commonly get here at LifeForce concerning coming to us first:


Do I need to have a referral to go to physical therapy first?

In North Carolina, you do not need a prescription in order to go directly for physical therapy treatment, however your insurance may require it.


Do I need to have an xray and/or MRI first in order to go to physical therapy? Don’t you need this to know what is going on?


We do not need these studies in order to treat you. We will take you through a comprehensive examination. Your therapist will test for signs that x-rays or more advanced studies are required, or if you are inappropriate for physical therapy treatment.


What can I expect?

You can expect to undergo a comprehensive examination, after all, we are experts in the neuro-musculo-skeletal system. We will discuss those findings with you along with the best, research supported treatments for your kind of back pain. We will discuss a treatment plan with you along with a timeline for progress.


How will you know my pain is not something more serious?

We determine this through a comprehensive exam asking about your symptoms, their behavior, and performing comprehensive clinical tests of the nervous system.


When is it inappropriate to see a physical therapist first for lower back pain?

If you have any of the following history or symptoms:

  • recent onset of incontinence/retention of the bladder/bowel
  • currently have metastatic cancer
  • have had recent, severe trauma
  • have relentless and severe pain at rest and cannot find ANY position of ease of pain


In case of any of the above symptoms associated with you lower back pain, you should see you physician or go to the emergency department.


Most back pain eventually goes away. We find learning to manage the health of your spine takes your pain away and, more importantly, you learn how to avoid future episodes. We also have strategies to reduce acute pain such as manual therapy techniques, taping, pain relieving exercises and positioning, use of at-home remedies, dry needling, and other modalities such as TENS and cold laser treatments. Opioids may take the pain away, but you may become addicted and never learn truly how to be in control and adapt healthy strategies to eliminate pain and improve the functioning of your back.


We also have strategies for those with a chronic history of lower back pain. In many cases, after going through a round of spine rehabilitation, patients are able to eliminate or significantly reduce their symptoms and return to the activities they love doing.

Exercise and Movement are Medicine!

This has long been a favorite video of mine from Dr. Mike Evans called 23 and ½ hours. It is from 2011, but still has a very important message for us all about exercise and movement as medicine. It applies not only to the neuro-musculo-skeletal system, but just about any disease process. If you are trying to improve your health, regular exercise will help.

If it hurts to exercise, or hurts to do the exercise/activities you love most, we can help. At LifeForce, we will listen to what your goals are and outline a strategy for return. We specialize in all levels of function. Whether your goal is to be able to walk or function normally in activities of daily living, or you are returning to an elite-level physical activity, we can help. We have long worked with elite-level performers, athletes, stunt performers and extreme athletes, and would look forward to working with you.