Shoulder impingement is one of the most common causes of should pain. The condition is similar to rotator cuff tendonitis of and bursitis. Due to the complex nature of the shoulder there are a number of structures that cross one and other to allow the joint to be as flexible as it is. With that said the joint is vulnerable to injury as there are structures that are closely located to one another an irritation to one of these tendons/muscles can cause issues in other area of the shoulder resulting in painful symptoms.
The shoulder joint is a ball and socket made up of three bones your scapular (shoulder blade) that contains the socket, the humeral which has the humeral head (the ball) and the clavicle (collar bone) that lays above them.
The shoulder joint is protected by a cluster of different bony structures and is held into position with various ligaments, also the rotator cuff that attaches onto the humerus and begin at the shoulder blade. The tendons of these muscles pass through a small space under the clavicle. When damage occurs to the tendons from overuse of from impact injury swelling occurs which reducing the space between the tendon itself and the bone surroundings. This causes symptoms and pain to present particularly when raising the shoulder up into the air.
Shoulder impingement can begin suddenly as a result of fall or incident or it can be gradual over time the most common symptoms include pan or weakness made worse by movement
Others may include:
- Pain made worse when raising your arm (especially above head hight)
- Weakness in your arm
- Pain /aching at night which may affect your sleep
- Pain in the top outside portion of the shoulder
- Pain radiating from the front of the shoulder into the side of the arm
In almost every of shoulder impingement case the treatment is nonsurgical. Also following conservative management may take several months most patients will see an improvement very quickly.
Nom surgical approach:
Rest – activity modification and avoiding any movements that provoke your pain
Non-steroidal anti-inflammatory drugs – NSAIDs can be used to reduce the pain and swelling at the shoulder drugs like ibuprofen and naproxen.
Rehabilitation program– your physiotherapist will initial focus on restoring normal function t the shoulders range of motion. With that will come the reduction of pain where you will then be focused on some strengthening exercises to stabilize the shoulder joint to limit the risk of anther injury. Most of the strengthening works will be based around the rotator cuff as it is responsible for the control at the shoulder.
Steroid injection – if conservative management is failing t improve symptoms before surgery becomes and option you may be rerecommended to have a steroid injection. A cortisone injection is an effective anti-inflammatory medicine that will relieve pain within the joint.
In some cases, conservative management may not relive you pain. If this is the case you may require a small minimally invasive procedure with the aim of creating a larger space for the structures of the shoulder to pass through. His surgery is normally completed using arthroscopic technique. When surgical instruments are inserted and part of the acromion removed to create a larger spacing for the tendons and bursa of the shoulder.