Impingement Syndrome of the Shoulder

Impingement syndrome describes a condition in which the tendons of the rotator cuff of the shoulder are pinched as they pass between the top of the upper arm (humerus) and the tip of the shoulder (acromion). The rotator cuff is a group of four muscles and bones that share a common tendon. On one end, the muscles are attached at different places on the shoulder blade; on the other, they attach to the upper end of the arm bone

When the muscles and tendons don't slide easily and normally, the tendons and bursa (a fluid-filled sac that protects the tendons) become irritated and swollen causing pain.

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Symptoms

Pain, tenderness and an inability to move the shoulder joint fully and normally are typical symptoms of impingement syndrome. Often, an injury sets off a circle of inflammation, swelling, more pressure on the tendons and bursa and more pain. 

Other symptoms include:

  • Pain or weakness when your arm is raised above your head or out away from the side of the body
  • Catching or grating of the muscles when you rotate or raise your arm
  • Not being able to sleep on the affected side because of the pain

Causes and Risk Factors

Many people who have this problem, have bones that are shaped in such a way that they simply have less space within the joint than most other people. Even slight swelling of the tendons or bursa can cause symptoms. Other factors that increase the risks of developing impingement syndrome of the shoulder are:

  • Injuries to the shoulder joint
  • Activities such as tennis, swimming, baseball and football that involve repetitive movements of the arm and shoulder
  • Age. People who are 50 or older are more likely to develop impingement syndrome than younger people.
  • Bone spurs that may develop from wear and tear on bones. This rough spot of bone irritate the surrounding tissue causing swelling
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Treatments

Treatment of impingement syndrome can range from simple home treatment such as aspirin and rest to surgery, depending on how severe your impingement is. 

Treatment may include any or a combination of the following:

  • Conservative medical care to reduce the swelling, relieve pain and rest the joint. Symptoms may slowly go away over a period of weeks. It may take several months to fully recover.
  • Drugs that reduce swelling, such as aspirin or ibuprofen
  • Avoiding any activities that cause pain, such as stretching or reaching past your comfort zone
  • Physical therapy, including exercises or stretching to strengthen the joint and preserve your range of motion
  • Cortisone or steroid injections. These may be used to reduce the swelling if other approaches don't make the symptoms go away. If your pain is severe, your doctor may give you a cortisone injection at your first visit.
  • Surgery