Initial treatment for this problem includes extensive physical therapy, and often times a cortisone injection into the space underneath the scapula where the inflammation occurs. If symptoms continue despite conservative treatment, surgical intervention is an option. Scapulothoracic bursectomy with medial angle resection is an arthroscopic procedure that is done using two to three small incisions around the shoulder blade, one used for visualizing the space with a camera (arthroscope) and the others used to insert surgical tools and instruments. The surgery involves removing the inflamed bursa located between the ribs and scapula and shaving off the bony prominence (medial angle) located on the undersurface of the scapula.
This surgery is performed on an outpatient basis, which means you will be able to go home that same day. You will be placed in a sling for the first four weeks after surgery and will only be allowed to move your elbow, wrist, and hand during this time. Four weeks after your surgery, the sling is removed and you will begin physical therapy, first to work on motion and eventually progress to strengthening. A typical recovery time is four to six months.