Summary about Disease
Impingement, often referred to as shoulder impingement or subacromial impingement syndrome, occurs when tendons of the rotator cuff muscles become compressed and irritated as they pass through a narrow bony space called the subacromial space. This space is located beneath the acromion (the bony projection at the top of the shoulder blade). The tendons can rub against the acromion, leading to inflammation, pain, and limited range of motion. While most commonly affecting the shoulder, impingement can occur in other joints like the hip or ankle.
Symptoms
Pain in the shoulder, often radiating down the arm.
Pain that worsens with overhead activities, reaching, or lifting.
Pain at night, especially when lying on the affected side.
Weakness in the shoulder.
Stiffness in the shoulder.
A clicking or popping sensation in the shoulder during movement.
Limited range of motion.
Causes
Overuse: Repetitive overhead activities (e.g., painting, swimming, throwing).
Bone Spurs: Abnormal bone growths (bone spurs) on the acromion.
Inflammation: Swelling of the bursa (a fluid-filled sac that cushions the rotator cuff tendons) or rotator cuff tendons themselves.
Poor Posture: Slouching or rounded shoulders.
Weak Rotator Cuff Muscles: Insufficient strength in the rotator cuff muscles.
Shoulder Instability: Excessive movement of the shoulder joint.
Anatomical Variations: Differences in the shape of the acromion.
Injury: Trauma to the shoulder.
Medicine Used
Pain Relievers: Over-the-counter pain relievers such as ibuprofen (Advil, Motrin) or naproxen (Aleve), or prescription pain medications.
Anti-inflammatory Medications: Prescription nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and pain.
Corticosteroid Injections: Injections of corticosteroids into the subacromial space to reduce inflammation.
Is Communicable
Impingement is not a communicable disease. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Avoid Overuse: Limit repetitive overhead activities.
Maintain Good Posture: Sit and stand with correct posture.
Strengthen Rotator Cuff Muscles: Perform exercises to strengthen the muscles that stabilize the shoulder.
Stretch Regularly: Stretch the shoulder muscles to improve flexibility and range of motion.
Use Proper Lifting Techniques: Lift objects with your legs, not your back and shoulders.
Take Breaks: Take frequent breaks during activities that involve repetitive shoulder movements.
Proper Warm-up: Warm up before exercise or activities.
How long does an outbreak last?
The duration of impingement symptoms can vary widely. It may depend on the severity of the impingement, the individual's overall health, and adherence to treatment. Symptoms can last from a few weeks to several months. Without treatment, chronic impingement can persist for a very long time.
How is it diagnosed?
Physical Examination: A doctor will assess the range of motion, strength, and tenderness in the shoulder.
Medical History: A discussion of symptoms, activities, and any previous injuries.
Imaging Tests:
X-rays: To identify bone spurs or other structural abnormalities.
MRI (Magnetic Resonance Imaging): To visualize soft tissues, such as the rotator cuff tendons and bursa.
Ultrasound: Can also visualize soft tissues and identify tears.
Timeline of Symptoms
The timeline of impingement symptoms can vary, but a general progression might look like this:
Early Stage: Mild pain with overhead activities, possibly resolving with rest.
Mid Stage: Pain increases in intensity and frequency, potentially impacting sleep. Range of motion starts to decrease.
Late Stage: Constant pain, significant limitations in range of motion, muscle weakness, and difficulty with everyday activities. This may lead to chronic pain if left untreated.
Important Considerations
Early diagnosis and treatment are important to prevent chronic pain and disability.
Physical therapy is a crucial component of treatment for impingement.
Surgery may be necessary in some cases where conservative treatment fails.
Lifestyle modifications, such as avoiding aggravating activities and maintaining good posture, are important for preventing recurrence.
Complete healing may take several weeks or months, even with proper treatment.