Shoulder Impingement Syndrome
Shoulder impingement most commonly occurs when the rotator cuff tendon or shoulder bursa becomes impinged (pinched) when the arm is lifted. Impingement is a common cause of inflammation, irritation and pain in the shoulder.
This condition is most common to people who perform manual labor and athletes. Repeated overhead arm movements (weightlifting, painting, etc.) can lead to this condition. Poor posture can also contribute to the development of an impingement. While most commonly associated with overuse, this condition can also develop as the result of trauma and the formation of bone spurs.
Impingement Symptoms
The most common symptoms of shoulder impingement syndrome is pain. Pain can occur when the arm if lifted and at night. Pain typically occurs at the top of shoulder or the outer side. Pain is typically minor but constant.
Other symptoms of an impingement include limited shoulder mobility and weakness.
Shoulder Impingement Diagnosis
A patients medical history will be reviewed and an orthopedic doctor will perform a physical exam. A doctor will manipulate the shoulder to reproduce symptoms. An X-ray is ordered to detect the presence of bone spurs and to assess the subacromial space. Other visual imaging test may be ordered to rule out other disorders or if damage to the rotator cuff is suspected.
An early diagnosis is important to accurately determine the cause of shoulder pain and inflammation. A patient can immediately modify or eliminate any activities that are causing or contributing to the impingement. If left untreated, this condition can lead to rotator cuff damage.
Non-Surgical Impingement Treatment
Most patients with shoulder impingement syndrome will not need surgery to treat the impingement.
Any physical activities that aggravate the condition may need to be temporarily avoided.
Conservative treatment for an impingement involves physical therapy and exercises to restore strength, stability and flexibility to the shoulder.
A patient might also benefit from the use cold packs and over the counter anti-inflammatory medication like ibuprofen and naproxen.
If a patient is not able to reduce or resolve their pain within a few weeks of conservative treatment, a cortisone injection may be used to help reduce inflammation in the shoulder.
Regenerative treatments like PRP Therapy may be considered for patients who have soft tissue damage (like a partially torn rotator cuff) caused by the impingement.
Shoulder Decompression Surgery
Surgery may be recommended if an orthopedic shoulder surgeon has determined the patient has bone spurs or a torn rotator cuff during the diagnosis.
Surgery may also be indicated for patients who are not able to resolve their pain using conservative treatments.
The objective of surgery is to create more space around the rotator cuff. A surgical procedure to treat an impingement is commonly done in a minimally invasive manner using an arthroscope. An open technique may be used if damage to the rotator cuff is severe.
Decompression surgery can involve one or more procedures. If a patient have developed bone spurs, they are removed. Bone spurs can press against the rotator cuff and bursa.
A surgical procedure can include the shaving of the acromion (acromioplasty). An orthopedic shoulder surgeon shaves the underside of the acromion bone to create more space around the rotator cuff and bursa to reduce compression.
If the rotator cuff is torn, a surgeon will repair the tendon during the procedure.
Shoulder Specialist at The CMD
If you are experiencing shoulder pain or discomfort, schedule an appointment with one of our orthopedic shoulder specialist. Our team of orthopedist are highly experienced at diagnosing and treating shoulder disorders and injuries.