Overview and Facts about Shoulder Impingement
Pain in your rotator cuff (the muscles and tendons that hold your arm in the shoulder socket) can occur because of inflammation or irritation due to:
- Shoulder impingement: the bone on the top of your shoulder (acromion) rubs against the rotator cuff tendons and fluid-filled sac called the bursa when you raise your arm
- Rotator cuff tendinitis: the tendons become inflamed or irritated
- Bursitis: the bursa becomes inflamed
Because shoulder pain can be due to injury in more than one area of the joint, it is important to seek medical attention to ensure you are pursuing the correct treatment.
Symptoms and Signs of Shoulder Impingement
Rotator cuff symptoms are typically mild at first, including pain when lifting or lowering your arm, as well as mild tenderness, swelling or stiffness.
When the injury gets more severe, symptoms may include:
- Severe tenderness
- Sharp, shooting or pinching pain
- Limited and painful movement
- Pain at rest and at night
- Loss of range of motion and strength
- Difficulty/pain when reaching behind your back
Causes and Risk Factors of Shoulder Impingement
Repetitive motions that put stress on your shoulder joint (such as throwing or participating in sports with overhead motions – swimming, baseball, tennis, etc.) put you at a higher risk for this type of injury. It is a common injury in young athletes and for anyone who works in a field where overhead motions are common, such as painting or construction.
Bursitis is often found in older adults and in those with certain medical conditions, such as diabetes, gout or rheumatoid arthritis.
Tests and Diagnosis for Shoulder Impingement
Your doctor will first discuss your medical history and symptoms, including any recent injuries. They will examine your shoulder to check for swelling, tenderness and range of motion. He/she may also order imaging tests, such as an X-ray, MRI or ultrasound to rule out other possible causes of injury and check for bone spurs, tearing or signs of inflammation.
Treatment and Care for Shoulder Impingement
Reducing your pain is the main goal in treatment for shoulder impingement, rotator cuff tendinitis and bursitis. Initial treatment begins with rest, ice compresses and physical therapy to improve range of motion and anti-inflammatory medications.
For bursitis, your doctor may recommend an injection of cortisone medication to assist with pain and rehabilitation.
For shoulder impingement or rotator cuff tendinitis that causes pain that is not relieved with non-surgical methods, you doctor may recommend arthroscopic surgery to repair and/or remove the inflamed area. After surgery, you will need to wear a temporary sling and begin a rehabilitation program to improve strength and achieve relief from pain.