Symptoms
Pain in the shoulder, especially when lifting the arm overhead or reaching behind the back.
Pain that may radiate down the arm.
Pain that worsens at night, particularly when lying on the affected shoulder.
Weakness in the shoulder muscles.
Stiffness in the shoulder.
A clicking or popping sensation in the shoulder during movement.
Limited range of motion in the shoulder.
Causes
Bone spurs: Abnormal bone growths on the acromion (part of the shoulder blade) that narrow the subacromial space.
Inflammation of the bursa: The bursa is a fluid-filled sac that cushions the rotator cuff tendons. Inflammation of the bursa (bursitis) can thicken the space and compress the tendons.
Rotator cuff tendon thickening or swelling: Repetitive overhead activities or injury can cause the tendons to swell or thicken, leading to impingement.
Poor posture: Slouching or rounded shoulders can alter the position of the shoulder blade, narrowing the subacromial space.
Weakness of rotator cuff muscles: If the rotator cuff muscles are weak, the humerus (upper arm bone) can migrate upward and compress the tendons.
Overuse: Repetitive overhead activities, such as throwing, painting, or swimming.
Shoulder blade (scapular) dyskinesis: Abnormal movement of the shoulder blade can contribute to impingement.
Medicine Used
Pain relievers: Over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help reduce pain and inflammation.
Nonsteroidal anti-inflammatory drugs (NSAIDs): Prescription NSAIDs, such as naproxen, can provide stronger pain relief and reduce inflammation.
Corticosteroid injections: Corticosteroids can be injected directly into the subacromial space to reduce inflammation and pain. These injections are typically used when other treatments have failed.
Muscle relaxants: May be prescribed to alleviate muscle spasms around the shoulder.
Is Communicable
No, impingement syndrome is not a communicable disease. It is a condition caused by structural or mechanical issues within the shoulder joint and is not caused by an infectious agent.
Precautions
Avoid repetitive overhead activities: Modify or avoid activities that aggravate the shoulder pain.
Maintain good posture: Sit and stand with good posture to keep the shoulder blade in a neutral position.
Strengthen rotator cuff muscles: Perform exercises to strengthen the rotator cuff muscles, which can help stabilize the shoulder joint.
Stretch shoulder muscles: Regularly stretch the shoulder muscles to improve flexibility and range of motion.
Use proper lifting techniques: When lifting objects, use proper body mechanics to avoid straining the shoulder.
Warm up before exercise: Before engaging in activities that involve the shoulder, warm up the muscles with light stretches and exercises.
Avoid sleeping on the affected side: If possible, avoid sleeping on the affected shoulder to prevent further irritation.
Listen to your body: Rest when your shoulder starts to hurt and avoid pushing through the pain.
How long does an outbreak last?
Impingement syndrome is not an "outbreak" that has a defined duration. It's a chronic condition that can last for weeks, months, or even years if left untreated. The duration of symptoms depends on the severity of the impingement, the underlying cause, and the effectiveness of the treatment. With appropriate treatment, many people experience significant improvement in their symptoms within a few weeks to a few months.
How is it diagnosed?
Physical examination: A doctor will assess the shoulder's range of motion, strength, and palpate for tenderness. Specific tests, such as the Neer test and Hawkins-Kennedy test, are performed to reproduce the pain associated with impingement.
Medical history: The doctor will ask about the patient's symptoms, activities, and any previous injuries.
Imaging tests:
X-rays: Can help identify bone spurs or other bony abnormalities.
MRI: Can provide detailed images of the soft tissues, including the rotator cuff tendons, bursa, and ligaments, and can help rule out other conditions, such as rotator cuff tears.
Ultrasound: Can also be used to visualize the rotator cuff tendons and bursa, and it can be performed dynamically to assess the movement of the shoulder joint.
Timeline of Symptoms
The timeline of symptoms can vary, but a typical progression might look like this:
Early Stage: Mild pain during overhead activities, often ignored. Pain may be present after activity.
Mid Stage: Pain becomes more frequent and intense, even with everyday activities. Pain at night starts. Weakness may develop.
Late Stage: Significant pain, even at rest. Marked weakness and limited range of motion. Chronic pain cycle may develop. Rotator cuff tear may occur as a complication of long-standing impingement.
Important Considerations
Early diagnosis and treatment are key: Prompt treatment can help prevent the condition from worsening and can improve the chances of a full recovery.
Physical therapy is crucial: A physical therapist can develop a personalized exercise program to strengthen the rotator cuff muscles, improve range of motion, and correct any underlying muscle imbalances.
Activity modification is essential: Avoiding activities that aggravate the shoulder pain is important to allow the tissues to heal.
Non-surgical treatment is often successful: Most cases of impingement syndrome can be effectively treated with conservative measures, such as rest, ice, physical therapy, and pain medication.
Surgery may be necessary in some cases: If conservative treatment fails to provide relief, surgery may be considered to widen the subacromial space and remove any bone spurs or inflamed tissue.
Complete rehabilitation after surgery is crucial: Following surgery, a comprehensive rehabilitation program is necessary to regain strength, range of motion, and function in the shoulder.
Addressing underlying causes is important: Identifying and addressing any underlying causes, such as poor posture or muscle imbalances, can help prevent recurrence.