Shouldering Impingement Pain

A common cause of shoulder pain is shoulder impingement syndrome. Impingement occurs when part of the shoulder bone rubs against the rotator cuff, causing pain and inflammation. Repeated overhead activities such as swimming, painting, and lifting put a person at risk. Shoulder impingement syndrome is usually treated conservatively, but surgery may be necessary in some cases.

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How does a pinch occur?

A rotator cuff is a group of muscles and tendons located in the shoulder. This structure allows shoulder and arm movements. After an injury or overuse, the rotator cuff can become inflamed. When the rotator cuff is swollen, the space between the rotator cuff and the acromion bone is reduced. This reduction of space leads to pinching or rubbing against the bone.

Pain in the shoulder

The most common symptom of shoulder impingement syndrome is shoulder pain. A person may also display other symptoms, such as shoulder or arm weakness and stiffness. The pain often occurs during activities and can worsen at night. Even little tasks, such as reaching for something on a high shelf, can hurt the shoulder.

Treating impingements conservatively

The initial treatment for shoulder impingement syndrome is typically a non-surgical approach. The main methods recommended are rest, ice application, physical therapy (PT), nonsteroidal anti-inflammatory drugs (NSAIDs), and steroid injections. Strong pain medications or steroid injections are typically reserved for more severe pain. Physical therapy includes a variety of exercises to improve the function and strength of the muscles.

When do I need surgery?

If the non-surgical treatments fail to diminish or stop the symptoms of shoulder impingement syndrome, then surgery may be recommended. The surgery is called a subacromial decompression, in which part of the acromion shoulder bone is removed. The removal of this bone allows the rotator cuff to have more space, eliminating the pinch.

Returning to regular activities

Usually, the patients may return to activities 2-4 weeks after shoulder surgery. Avoid any overhead activities while recovering and instead focus on low-impact exercises. A physical therapist can help slowly re-incorporate shoulder movement into daily life as the treated area heals and strengthens.

Life after shoulder treatment

With conservative treatments, such as rest and PT, patients will see better results in 3-6 months if proper instructions are followed. Severe cases of shoulder impingement may require up to 1 full year of recovery. In some cases, surgery may be necessary, lengthening the recovery time.

The bottom line

Shoulder impingement syndrome causes shoulder pain that affects daily activities. The good news is that most of the time, conservative treatments can eliminate or significantly reduce pain. Surgery is only required if non-surgical methods fail. To reduce the risk of shoulder impingement syndrome in the future, avoid or decrease repetitive overhead activities when possible.

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