Bone spurs are the most important cause of pain in shoulder joint, they are very commonly seen in the population. These bone spurs constantly rub against the rotator cuff, causing inflamation. This is called impingement syndrome.

This leads to a painful condition of the shoulder leading to secondary stiffness , the so called frozen shoulder in layman's terminology. They also make rotator cuff more prone to tears.

Arthroscopy has now become the gold standard in the treatment of the bone spurs. We can trim the bone spurs with special instruments called burrs and shaver.

Neer describes the following 3 stages in the spectrum of rotator cuff impingement:

Stage 1, commonly affecting patients younger than 25 years, is depicted by acute inflammation, edema, and hemorrhage in the rotator cuff. This stage usually is reversible with nonoperative treatment.

Stage 2 usually affects patients aged 25-40 years, resulting as a continuum of stage 1. The rotator cuff tendon progresses to fibrosis and tendonitis, which commonly does not respond to conservative treatment and requires operative intervention.

Stage 3 commonly affects patients older than 40 years.  As this condition progresses, it may lead to mechanical disruption of the rotator cuff tendon and to changes in the coracoacromial arch with osteophytosis along the anterior acromion. Surgical l anterior acromioplasty and rotator cuff repair is commonly required.