Shoulder Impingement Syndrome

Shoulder impingement syndrome is one of the most common causes of shoulder pain for adults. It's common in athletes and in adults middle-aged and older. Athletes who frequently raise their arms overhead in sports such as swimming, tennis and baseball often experience this syndrome. Construction workers and painters are also vulnerable to shoulder impingement. Pain may develop from trauma or even from no apparent cause.

The Facts

• Shoulder impingement syndrome affects the rotator cuff, which is a group of muscles and tendons securing the arm to the shoulder joint. The rotator cuff allows the shoulder to rotate. This condition often occurs along with bursitis or tendonitis.

Signs and Symptoms

• Symptoms include pain that occurs from the top of the shoulder to the elbow, and shoulder muscles may become weak. There may be swelling and tenderness in the front of the shoulder. You may have difficulty reaching behind your back, and you may experience intense pain when reaching over your head. Pain may flare up when sleeping due to pressure on the shoulder muscles. Without treatment, pain may worsen.

Diagnosis

• Your doctor will review your health history and focus on activities in which you use your shoulder. He will feel the area to find the exact location of the pain. An x-ray will be taken to rule out arthritis. Additional tests may be ordered, such as an MRI, which can show fluid in the bursa or tears in the rotator cuff. An impingement test involves injecting an anesthetic into the bursa and can confirm the diagnosis of shoulder impingement.

Treatment

• Most people who have shoulder impingement can be successfully treated with medication, stretching and temporarily avoiding overhead movements. Treatment begins with rest and ice packs to the injured shoulder. Anti-inflammatory medication such as aspirin, ibuprofen or naproxen may provide some relief, but may need to be used consistently for up to 8 weeks to be effective. Your doctor may recommend stretching and strengthening exercise. Corticosteroid injections may reduce inflammation, or physical therapy may be recommended. If there is significant weakness, your doctor may order an MRI or other tests to rule out a rotator cuff tear.

Self Care

• If you have been diagnosed with shoulder impingement syndrome, avoid repetitive motions with your injured shoulder, such as painting, raking and vacuuming. Avoid lifting heavy objects that increase your pain. It may take anywhere from 2 to 4 months to attain complete relief of pain.