Shoulder Impingement

Shoulder impingement is the condition of inflammation of the tendons and bursa of the shoulder joint. It is one of the most common causes of pain in the adult shoulder. The shoulder is a 'ball-and-socket' joint. A ‘ball' at the top of the upper arm bone, humerus, fits neatly into a 'socket’, called the glenoid, which is part of the shoulder blade, or scapula. Shoulder impingement is also called swimmer’s shoulder, tennis shoulder,rotator cuff tendinitis or subacromial bursitis

Causes

Impingement results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It is more likely to occur in young and middle aged people who engage in physical activities that require repeated overhead arm movements. The pain may be due to a "bursitis" or inflammation of the bursa overlying the rotator cuff or a "tendonitis" of the cuff itself. In some circumstances, a partial tear of the rotator cuff may cause impingement pain.

Symptoms

Individuals with shoulder impingement may experience severe pain at rest and during activities, weakness of the arm and difficulty in raising the hand overhead.

Diagnosis

Diagnosis involves a thorough history and physical examination by the doctor, along with X-rays and MRI scans as needed.

Conservative Treatment Options

Shoulder impingement can usually be treated with rest, ice packs, anti-inflammatory drugs, and avoiding the aggravating activities involving the shoulder. Physical therapy may be advised to strengthen the muscles and steroid injections may be given if pain persists.

Surgery

Arthroscopic surgery is recommended if conservative treatment fails. During surgery the inflamed bursa is removed and any other damage in the shoulder joint is addressed.