Among the top three complaints in orthopedic care is shoulder pain. Often, the source of this pain is shoulder impingement. This condition makes it difficult to reach overhead, causes sleeping problems and affects range of motion.

Treatment for shoulder impingement includes resting the shoulder and physical therapy, among other non-invasive treatments. The goal of treatment is to relieve the pain caused by impingement and improve joint mobility.

What is Shoulder Impingement?

When the soft tissues of the shoulder are pinched, you have shoulder impingement. The shoulder is comprised of soft tissue structures sandwiched between bones. This includes the bicep tendon, rotator cuff, which includes four small muscles, ligaments and bursa. The area containing all these structures is called the subacromial space. This is located just about the shoulder’s ball and socket joint but below the top-most bone of the shoulder, which is called the acromion.

When you raise your arm, this space becomes smaller. With shoulder impingement, pain results from the pinching of these soft tissues. It can also cause limited range of motion.

Causes

Shoulder impingement can be caused by overuse. Certain occupations requiring repetitive heavy lifting overhead can irritate and inflame the soft tissues of the shoulder, resulting in swelling. If the tissues in the subacromial space become swollen, they are more likely to be pinched. Sports with repetitive overhead motions, such as swimming and baseball, can also cause shoulder impingement.

Arthritic changes to the bones can cause the subacromial space to become smaller. This can also happen as a result of natural bone shape. Some individuals have a curved or hooked acromion, which causes them to be more vulnerable to shoulder impingement because the anatomy results in a smaller subacromial space.

Injuries to the rotator cuff or a torn labrum can cause swelling and result in shoulder impingement. Conversely, shoulder impingement due to another cause can result in a rotator cuff tear or a torn labrum.

Poor posture is another source of shoulder impingement. Hunching over a keyboard for hours or slumping your shoulders narrows the space between the acromion and the rotator cuff. Poor posture while reading, driving and cooking can develop into this condition.

Symptoms of Shoulder Impingement

There are several symptoms associated with shoulder impingement.

• A pinching sensation during certain movements is often reported. This sensation is felt at the top of the shoulder when throwing a ball, reaching behind the back to zip or button a shirt or dress, reaching up to retrieve and object from a shelf overhead, etc.
• Decreased range of motion that can make everyday activities such as brushing your hair difficult.
• Radiating pain that travels from the shoulder to the side of the upper arm. You may feel this pain when lifting objects or reaching overhead. The pain does not usually go further than the elbow, but it may radiate into the neck.
• Intermittent pain may come and go with certain movements. This pain in and around the shoulder may become more frequent over a period of time.
• Night pain or pain while lying on the side with the impingement.
• Weakness in the shoulder may be felt. You may feel like your shoulder is going to give out when you use it, and you may have a feeling of weakness even when not using it.
• Swelling or tenderness may be present.

Symptoms vary from person to person. You may have only one of the symptoms or possibly most or all of them.

Treatment

Non-surgical treatment is usually advised for shoulder impingement. The goal of treatment is to reduce the inflammation of the soft tissues and improve range of motion. Pain relief and restoration of joint function are also primary goals. Improving muscle strength and posture will increase the subacromial space and help reduce discomfort.

Treatment options involve:

• Rest – Avoid overhead activities and sports that require movements such as throwing or swinging your arms. Total immobilization is not productive, but frequent shoulder movement should be kept to a minimum.
• Physical therapy provides exercises to increase range of motion and help strengthen weak muscles. You may also be encouraged to do certain exercises at home. These will help with a faster recovery.
• Over-the-counter pain relievers may be advised to help reduce pain and inflammation.
• Alternative treatment options – These may include chiropractic care and acupuncture.

Surgery is always a last resort for shoulder impingement. Non-invasive treatment options are often effective for resolving this condition.

The pain and discomfort of shoulder impingement can be successfully treated with the cutting-edge technologies available at Manhattan Sports Therapy. We are specialists in pain relief for all types of pain. Contact our pain management physicians today to schedule an appointment for consultation and assessment.