Impingement syndrome is a common condition affecting the shoulder often seen in aging adults. This condition is closely related to shoulder bursitis and rotator cuff Tendinitis. These conditions may occur alone or in combination.

When an injury occurs to the rotator cuff muscles, which encase the shoulder joint, they respond by swelling. However, because the rotator cuff muscles are surrounded by bone, when they swell a series of other events occur.

The pressure within the muscles increases, which results in compression and loss of blood flow in the small blood vessels. When the blood flow decreases, the muscle tissue begins to fray like a rope. Motions such as reaching up behind the back or reaching up overhead to put on a coat or blouse, for example, may cause pain.

What Are the Symptoms of Shoulder Impingement Syndrome?

The typical symptoms of impingement syndrome include difficulty reaching up behind the back, pain with overhead use of the arm and weakness of shoulder muscles.

If these muscles are injured for a long period of time, the muscle can actually tear in two, resulting in a rotator cuff tear. This causes significant weakness and may make it difficult for the person to elevate his or her arm. Some people will have rupture of their biceps muscle as part of this continuing impingement process.

How Is Impingement Syndrome Diagnosed?

Diagnosis begins with a medical history and physical examination by your doctor. X-rays will be taken to rule out arthritis and may show changes in the bone that indicate injury of the muscle. Bone spurs or changes in the normal contour of the bone may be present. Impingement syndrome may be confirmed when an injection of a small amount of an anesthetic into the space under one of the shoulder bones relieves pain.

How Is Shoulder Impingement Syndrome Treated?

Oral anti-inflammatory medications—such as aspirin, naproxen or ibuprofen, remain the most common treatment for this condition.

You must consistently take the medication for nearly eight weeks for it to be effective. You should do this under the care of a doctor because these medications can cause stomach irritation and bleeding.

Taking anti-inflammatory medications for a short period of time may treat the symptom of pain, but it will not treat the underlying problem and symptoms will come back. There is no specific medication for this condition and response to any given medication differs from person to person. If one anti-inflammatory medication does not help within 10 to 14 days, then another one will be given until one that provides relief is found.

In addition to taking medications, daily stretching in a warm shower will help. Work to reach your thumb up and behind your back. Avoid repetitive activities with your injured arm, particularly where the elbow would move above shoulder level. Avoid vacuuming, painting, raking leaves and washing the car. Your physician may refer you to a physical therapist who can demonstrate the exercises most effective in strengthening and stretching the shoulder muscles.

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