Dr. Shiva

Shoulder impingement occurs due to bursitis, tendinitis or bony impingement. Repeated overhead exercises or intense physical activity concentrated around your shoulder is a common risk factor for shoulder impingement. The examples of such activity would include playing outdoor sports like tennis, swimming etc. or painting for long hours. 

How it may affect your daily life?
Shoulder impingement pain is severe in many cases and may affect your everyday activities. In fact, any activity, which involves your shoulders can cause intense pain. You should consult a doctor or a professional medical facility to get relief from pain as well as to avoid aggravating the injury.

Symptoms of shoulder impingement:

1. You will have difficulty in completing tasks which involve your back.
2. There may be a weakness in your shoulder muscles.
3. Pain associated with overhead use of your arm. Anytime you lift your arm there would be pain and would make many day to day activities difficult.
4. Intense injury to the tendons can cause them to tear into two and would result in a rotator cuff injury and would make your arm movements next to impossible.

Diagnosis of shoulder impingement:
Physical exam and review of medical injury previously sustained on some other occasion is the first step of treatment. Your doctor may also diagnose shoulder impingement by X-rays or MRI of shoulder to see changes in the bone that may indicate any injury. Other changes in the normal contour of the bone may also be checked which may help in further diagnosis and treatment.

Treatment of shoulder impingement:

It should not be given in partial or complete tear of the rotator cuff tendon. NSAIDs are anti-inflammatory medicines that are commonly prescribed for shoulder impingement syndrome. These are prescribed for two weeks. Shoulder impingement requires a long time to heal and would require regular consultation with your doctor. If the medications fail to provide any relief in a span of maximum two weeks it may compel your doctor to change the course of treatment. Shoulder impingement is a serious injury and requires proper rest for your shoulder as well as patience as it may take quite some time to come back to normal.

Corticosteroid injection is helpful in relevant pain as it reduces inflammation. It should not be given in partial or complete tear of the rotator cuff tendon.

In the shoulder, they are particularly useful in the management of:

1. Rotator cuff disease (degenerative tendonosis, impingement, subacromial bursitis)
2. Adhesive capsulitis (or ‘frozen shoulder’)
3. Glenohumeral osteoarthritis
4. Acromioclavicular joint disease (osteoarthritis or osteolysis)

Physiotherapy for Impingement:

Physiotherapy is usually the first line of treatment for subacromial impingement (tendonitis, bursitis) of the shoulder; along with anti-inflammatories and analgesia. It is very successful in treating shoulder impingement syndrome. You will work with your physical therapist to devise a treatment plan that is specific to your condition and goals. Your individual treatment program may include:

1. Pain Management
2. Manual techniques, such as gentle joint movements, soft-tissue massage, and shoulder stretches to get your shoulder moving properly.
3. You will learn exercises and stretches to help your shoulder and shoulder blade move properly.
4. Strengthening Exercises
5. The therapist will teach you the proper posture which is an important part of rehabilitation
6. ultrasound Massage

And in case physiotherapy fails, arthroscopic sub acromial decompression is the best treatment option.