Summary about Disease
Shoulder impingement syndrome, also known as subacromial impingement, occurs when tendons of the rotator cuff muscles become compressed or irritated as they pass through the subacromial space (the space between the acromion and the humerus). This compression can lead to pain, weakness, and limited range of motion in the shoulder. It's a common cause of shoulder pain, particularly in athletes involved in overhead activities and individuals with certain shoulder abnormalities.
Symptoms
Pain, often described as a dull ache, that can radiate down the arm.
Pain that worsens with overhead activities or when reaching behind the back.
Pain that may be present at night, especially when lying on the affected shoulder.
Weakness in the shoulder muscles.
Stiffness or limited range of motion in the shoulder.
A clicking or popping sensation in the shoulder during movement.
Causes
Anatomical factors: Bone spurs (osteophytes) on the acromion, variations in the shape of the acromion, or an abnormal curve of the clavicle.
Repetitive overhead activities: Sports like swimming, baseball (pitching), tennis, volleyball, and occupations involving repetitive lifting or overhead work.
Rotator cuff tendinopathy: Degeneration or inflammation of the rotator cuff tendons.
Bursitis: Inflammation of the bursa (a fluid-filled sac that cushions the shoulder joint).
Shoulder instability: Excessive movement of the shoulder joint.
Poor posture: Rounded shoulders can narrow the subacromial space.
Trauma: A direct blow to the shoulder or a fall.
Medicine Used
Pain relievers: Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or naproxen (Aleve) to reduce pain and inflammation. Acetaminophen (Tylenol) can help with pain but doesn't reduce inflammation.
Corticosteroid injections: Injections of corticosteroids into the subacromial space to reduce inflammation and pain. These are often used when oral medications are not effective.
Muscle relaxants: May be prescribed to relieve muscle spasms.
Topical pain relievers: Creams or patches containing medications like NSAIDs or lidocaine.
Is Communicable
Shoulder impingement syndrome is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Avoid activities that aggravate the pain: Modify or temporarily discontinue activities that worsen shoulder pain.
Maintain good posture: Practice proper posture to avoid rounding the shoulders forward.
Strengthen shoulder muscles: Perform exercises to strengthen the rotator cuff and scapular muscles.
Stretch regularly: Incorporate stretching exercises to improve shoulder flexibility and range of motion.
Use proper lifting techniques: Avoid lifting heavy objects overhead and use proper form when lifting.
Warm-up before exercise: Always warm up your shoulder muscles before engaging in physical activity.
Take breaks: If you perform repetitive overhead activities, take frequent breaks to rest your shoulder.
How long does an outbreak last?
There is no "outbreak" in the context of shoulder impingement. Shoulder impingement is a condition that develops over time or due to an injury, not an infectious outbreak. The duration of symptoms varies significantly. It can range from a few weeks to several months or even years, depending on the severity of the impingement, the individual's response to treatment, and their activity level.
How is it diagnosed?
Physical examination: A doctor will assess your range of motion, strength, and tenderness in the shoulder. Specific tests, like the Neer and Hawkins tests, are often performed to check for impingement.
Medical history: The doctor will ask about your symptoms, activities, and any previous shoulder injuries.
Imaging tests:
X-rays: To rule out other conditions, such as arthritis or fractures, and to identify bone spurs.
MRI (Magnetic Resonance Imaging): To visualize the soft tissues of the shoulder, including the rotator cuff tendons, bursa, and labrum. This can help identify rotator cuff tears, bursitis, or other soft tissue abnormalities.
Ultrasound: Can also be used to visualize soft tissues and detect rotator cuff tears or bursitis.
Timeline of Symptoms
The timeline of symptoms can vary, but a general progression may look like this:
Early Stage: Mild pain with overhead activities or reaching behind the back. Pain may be intermittent and relieved with rest.
Intermediate Stage: Pain becomes more frequent and severe, even with simple movements. Pain may be present at night, disrupting sleep. Weakness in the shoulder muscles may develop.
Advanced Stage: Constant pain that interferes with daily activities. Significant weakness and limited range of motion. Potential for rotator cuff tears or other complications.
Important Considerations
Early diagnosis and treatment are crucial: Addressing the problem early can prevent the condition from worsening and potentially avoid the need for surgery.
Physical therapy is a key component of treatment: A physical therapist can guide you through exercises to strengthen the rotator cuff and scapular muscles, improve posture, and restore range of motion.
Surgery may be necessary in some cases: If conservative treatments (medication, physical therapy) are not effective, surgery to decompress the subacromial space may be considered.
Compliance with treatment is essential: Following your doctor's and physical therapist's recommendations is important for a successful recovery.
Prevention is key: Taking steps to prevent shoulder impingement, such as maintaining good posture, strengthening shoulder muscles, and avoiding repetitive overhead activities, can help reduce your risk.