Shoulder Impingement Syndrome: Risk Factors & Treatment Options

Shoulder impingement syndrome is a condition seen in aging adults as well as young athletic people and those who have suffered a traumatic injury. In each group, there are many causes of this condition, but the resulting pain and limited mobility ca n be very frustrating. Impingement occurs from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted.

The rotator cuff is a tendon that links four muscles: the supraspinatus, the infraspinatus, the subscapularis and the teres minor. These four muscles cover the head of the humerus (the ball of the shoulder) and work together to provide movement for lifting and rotation of the shoulder.

The acromion is the front edge of the shoulder blade and sits over and in front of the humeral head. When the arm is lifted, the acromion rubs, or impinges on the surface of the rotator cuff causing pain and limiting movement. The pain associated with this type of injury is actually caused by a bursitis, or inflammation of the bursa overlying the rotator cuff, or a tendonitis of the cuff itself. In some cases, a partial tear of the rotator cuff may cause impingement pain.

Risk Factors
There are several risk factors for shoulder impingement, and age can be an underlying cause of the injury. Studies have shown that nearly two-thirds of the population at age 70 have rotator cuff tears but have had no symptoms to indicate a problem. In such cases, traumatic injury can cause an otherwise asymptomatic shoulder condition to become symptomatic and problematic. Common risk factors include:

• Sports such as swimming, baseball and tennis
• Repetitive lifting activities
• Overhead activities such as paper hanging, painting or construction
• Trauma

Symptoms
Initially, symptoms of shoulder impingement are frequently mild. Sometimes the patient does not perceive the issue as significant be enough of a problem to seek treatment. Patients should look for the following:

• minor pain that is present during activity and rest
• pain that radiates from the front of the shoulder to the side of the arm
• sudden pain with lifting and reaching movement
• pain which occurs while performing certain activities (throwing a ball, painting, etc.)

As the injury progresses, patients should also look for the following conditions:

• local swelling and tenderness in the front of the shoulder
• increased pain and stiffness when the arm is lifted or when the arm is lowered from an elevated position
• night pain
• loss of strength and motion
• difficulty performing activities that require arm movement behind the back
• “frozen shoulder” in very advanced cases

Diagnosis & Treatment
In order to diagnose shoulder impingement an orthopedic surgeon physically examines the shoulder and reviews the medical history of the patient. X-rays of the shoulder are helpful to rule out arthritis and also to detect any possible bone spurs. Finally, the injury may require an MRI (magnetic resonance imaging) scan to show fluid or inflammation in the bursa and rotator cuff, or in some cases tearing of the rotator cuff. Impingement syndrome may also be confirmed when an injection of a small amount of an anesthetic into the space under the acromion relieves pain.

Impingement syndrome is most frequently treated by a regimen of oral anti-inflammatory drugs such as aspirin, naproxen or ibuprofen. Typically the patient would consistently take these medications for nearly eight weeks to treat the condition. Sometimes the anti-inflammatory drugs relieve the pain and the patient may wish to stop taking them but the condition that causes the pain may require the entire eight weeks of oral anti-inflammatory drug therapy. There is no specific oral medication used, so if a patient is not responding to one type of medication after ten to fourteen days another medication may be substituted by a physician in an effort to gain better results.

Along with pain medication, patients may be instructed to perform daily stretching exercises, especially during a warm shower, in an effort to regain range of motion. Patients may be cautioned to eliminate repetitive motion activities in order to allow healing of the sore muscle. The doctor may also recommend a formal physical therapy program for the patient.

If symptoms persist in spite of the oral medications a cortisone type injection into the shoulder may be considered by the doctor. Cortisone is a potent anti-inflammatory and should only be used in serious cases because it can weaken the muscle tendon tissue.

Finally, if the rotator cuff is torn (as diagnosed by an MRI) surgery may be necessary.

Many patients are successfully treated with medication, stretching exercises and temporary avoidance of the activity that caused the initial injury.

If you or a loved one is suffering from a shoulder injury due to the negligence of another, you can find answers to many of your questions on this website. You can also use our “just ask” section to send us your question or our live chat for immediate response. For more information, download our FREE book, 10 Essential Steps You Must Take to Protect Your Personal Injury Claim.

For more information on these topics please contact Kansas City Accident Injury Attorneys by calling (816) 471-5111. Kansas City Accident Injury Attorneys has over 15 years of experience handling serious injury claims, including many shoulder injury cases, and any questions will gladly be answered.

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