A Painful Shoulder Condition

Shoulder impingement syndrome can best be described as a recurring ache/pain on the outside upper part of your shoulder when you raise your arm to shoulder height.

Impingement syndrome occurs due to pinching and inflammation of the rotator cuff tendon and bursa in the space below the acromion (see photo). The pain is worse when the arm is raised away from the body.  It is a very common condition that, if diagnosed early, can be treated very effectively.

Common Causes

Sometimes referred to as swimmer’s shoulder, this syndrome is common with people who perform repetitive arm rotations when exercising or working. These types of repetitive stress injuries can occur with athletes and those with assembly line jobs.

Impingement usually occurs from repetitive and chronic compression of the rotator cuff tendons in the subacromial space. These tendons help hold your arm in place, provide shoulder stability and enable movement.

Damage to any one of the four rotator cuff muscles could result in inflammation and swelling and general pain in the shoulder, or cause shoulder impingement.  Rotator cuff tears and impingement problems can exist separately or together. It is possible that rotator cuff tears are the result of impingement syndrome and age-related changes within the rotator cuff tendons.

Additionally, aging patients may develop arthritis which can cause bone spurs (boney growths formed on a normal bone) these further narrow the space below the acromion causing impingement. Again, this is common in older patients who participated in sports such as swimming, tennis, racquetball, baseball or work activities that require overhead positions.

Unlike some rotator cuff tears, impingement symptoms are marked by pain. Motions such as reaching up behind the back or reaching up overhead to put on a coat or blouse, for example, will hurt. Overhead motions tend to increase the pain drastically. The discomfort usually increases at night due to the amount of inflammation that builds during the day.

Before you see the doctor

The first course of action is to reduce the swelling and pain. Things you can try at home include:

• Applying ice
• Wearing a compression sleeve
• Discontinuing any activities that may have contributed to overuse of the shoulder

If the shoulder pain doesn’t go away or worsens, see a shoulder specialist. It’s important to properly diagnose your condition to ensure you’re getting the best treatment. A specialist will evaluate your X-ray or MRI and determine a care plan. Non-surgical treatments may include activity modifications, physical therapy and/or a cortisone shot to ease the pain.  If there is no improvement in your strength or the injury worsens over time, surgery may be the best option to restore function and alleviate pain. We’re here to help. Call 844-SHOULDR (844-746-8537) to schedule an appointment.

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The Gobezie Shoulder Institute treats patients with all types of shoulder and elbow disorders resulting from traumatic injuries, arthritis, instabilities, rotator cuff and sports-related injuries. Led by nationally recognized Orthopedic Surgeon Reuben Gobezie, MD, the institute provides both surgical and non-operative treatments.

Dr. Gobezie is one of the country’s top specialists in advanced arthroscopic and open surgical techniques to restore damaged joints, ligaments and bones. He is also one of the most experienced and highest volume shoulder surgeons in the country. A number of studies have shown that surgical volume, the number of surgeries a surgeon performs each year, is a strong predictor of patient outcome. The more surgeries that a doctor and his surgical team performs, the better the results for patients.