Shoulder Impingment Treatment

Shoulder impingement is the term used for abnormal compression of the rotator cuff muscles by the shoulder blade. It is a major cause of shoulder pain, and typically affects middle-aged individuals or athletically active adults of any age. Treatment of shoulder impingement is typically as conservative as possible, and may include rest, exercise and medication or surgery and post-surgical rehabilitation.

Understanding Shoulder Impingement

• The rotator cuff is a group of four muscles (and associated tendons) responsible for stabilizing the shoulder joint and halting the momentum of arm movements. The cuff also holds the humerus (upper arm bone) in its socket. Injury of these muscles occurs when the upper wing of the shoulder blade (an area known as the acromion) rubs against the rotator cuff, irritating either the sac (bursa) protecting the cuff or the muscles themselves. In some cases, an actual tear of the rotator cuff muscles occurs. If you experience shoulder impingement, your symptoms may include sharp pain during reaching or lifting movements, or radiating pain that extends to the outside of the arm. You may also experience low-level pain even when your shoulder is inactive.

First Treatment Options

• Your doctor will begin treating your shoulder impingement with the least invasive methods available. Rest is usually the first step, since ceasing activity will allow any inflammation time to subside. In addition, your doctor may ask you to temporarily restrict any overhead movements, or stop any work or leisure activities that worsen your condition. Icing your shoulder may also help. If you choose this therapy, limit individual applications of ice to a maximum of 20 minutes, and remember that ice should never be applied directly to the skin. While immobilization of the joint is used to treat some arm or shoulder injuries, this is not the case with shoulder impingement.

NSAID Medications

• Your doctor may also recommend use of a non-steroidal anti-inflammatory (NSAID) medication to further reduce inflammation. Common over-the-counter NSAIDs include ibuprofen, aspirin and naproxen. Be aware that NSAIDs may cause a number of side effects. As a result, their use should only be temporary. Consult your doctor for full guidelines on NSAID use.

Exercise

• Exercise is an important part of treating your shoulder impingement. As soon as you can use your shoulder without acute pain, begin exercising to strengthen the rotator cuff and other muscles of the shoulder. Components of successful rotator cuff strengthening typically include stretching and weight lifting. Consult a physical therapist for the full details of an appropriate exercise program.

Corticosteroids

• If your shoulder does not improve through these more conservative methods, your doctor may choose to treat you with a corticosteroid such as prednisone. These compounds are powerful anti-inflammatories, and they frequently bring quick relief. However, regular use of corticosteroids can damage your shoulder either further, so your doctor will have to gauge how often these medications can be used.

Surgery and Rehabilitation

• If your shoulder still does not improve, your doctor may elect to perform surgery to shave or remove any material that is aggravating your rotator cuff. If this is the case, follow surgery with a rehabilitative physical therapy program to strengthen your shoulder and rotator cuff.