Non-Surgical Shoulder Impingement Treatments

A shoulder impingement occurs when the space between the humerus and acromion bones place too much stress on the rotator cuff during arm movement. This usually occurs because of inflammation in the rotator cuff muscles (there are four of them), which converge at the shoulder joint. The bones can also thicken and cause this condition. Non-surgical shoulder impingement treatment can vary depending on the severity of the injury or if there is a rotator cuff tear. Typically, treatment includes a combination of rest, medications, stretching and resistance exercises.

• A shoulder impingement can greatly limit movement.

Effects of Rest, Ice and Heat

• Non-surgical treatment for a shoulder impingement usually commences with a period of rest to allow time for ice to reduce inflammation and pain. It also temporarily prevents further aggravation of the condition. Ice causes vasoconstriction, which reduces inflammation and pain by minimizing the flow of blood and lymph fluids to the area. Ice can be compressed on the affected area at 20-minute intervals for the first 48 hours. Elevating the shoulder above the heart can also help reduce inflammation. Once inflammation has been reduced, heat can promote blood flow to the area.

Types of Medication

• Anti-inflammatory medications such as ibuprofen and naproxen are often used for shoulder impingements. These medications are Cox-2 inhibitors, which reduce inflammation and pain by minimizing the reactions of Cox-2 enzymes and prostaglandins (part of the body's natural response to injuries). In some cases, oral steroids may be prescribed or cortisone shots can be given to relieve pain and inflammation.

Other Types of Treatment

• Stretching and resistance exercises are often recommended for a shoulder impingement once the initial swelling has subsided. Gentle stretching exercises can help relieve stiffness and prevent frozen shoulder (adhesive capsulitis), which occurs when pain limits arm movement. Stretching is sometimes done after two or more days of rest. Light resistance training with dumbbells, for example, can enhance healing by increasing blood flow to the rotator cuff muscles. Holding a dumbbell at 90 degrees in front of the body and moving it outward and back is one such exercise. Shoulder rolls, shrugs or elastic band exercises can also help alleviate pain and inflammation in the rotator cuff area. At times, electric shock treatments have been used to treat shoulder impingements.

Time Frame

• There is no set time frame for overcoming a shoulder impingement without surgery. It may take weeks of ice, anti-inflammatory drugs and exercise to overcome the inflammation and pain. Those who are more proactive in their treatment generally recover more quickly.

Considerations

• According to the American Academy of Orthopaedic Surgeons, surgery may be required if non-surgical treatment does not relieve pain. Surgery can provide more room for rotator cuff movement between the acromion and humeral head.