Shoulder pain is very common; in fact, it is the third most common musculoskeletal disorder – back pain being the first and neck pain the second. Often the primary cause of shoulder pain is shoulder impingement – a condition which is similar to shoulder bursitis and rotator cuff tendinitis. The information below sheds some light on shoulder impingement and the common symptoms, causes and from diagnosis to treatment.
Shoulder Impingement – What is it?
Shoulder impingement or shoulder impingement syndrome is a very painful condition of the shoulder joint which occurs as a result of mechanical compression and/or wear and tear of the rotator cuff tendons.
The rotator cuff is a group of four rubbery tissues that connect the shoulder blade (scapula) to the upper part of the shoulder joint (humeral head). The four tissues of the rotator cuff perform several important functions such as:
- contribute to most movements of the shoulder
- stabilize the shoulder joint during movement
- prevent dislocation
- contributes to shoulder strength
Impingement of tendons can be caused by a number of things, such as:
- overuse injuries
- weakening or degeneration due to aging
- formation of bone spurs
All of these factors compromise the normal gliding function of the shoulder joint and thus prevent correct movement. The affected person is unable to perform common everyday activities such as putting on a coat or blouse, brushing hair, or reaching up to a cupboard. If not treated in a timely manner, impingement may compromise the strength and functionality of the rotator cuff tendons.
Shoulder Impingement – Symptoms
The symptoms associated with shoulder impingement syndrome are usually mild at first but can worsen over time. These symptoms can start suddenly or show up gradually; here are some common symptoms of shoulder impingement:
- sharp pain in the top and outer portion of the shoulder
- shoulder stiffness
- shoulder tenderness
- decreased range of shoulder motion
- a clicking sound during shoulder movement
- pain that gets worse at night
Shoulder Impingement – Causes & Risk Factors
Shoulder impingement results from the inflammation of the rotator cuff tendons and the bursa. Often, the inflammation is triggered by an acute strain or traumatic injury, after that, the process of thickening of tendons and bursa continues making the condition worse. Here are some contributing factors that can cause acute strain or traumatic injury to the rotator cuff tendons and make them inflamed:
- repeated overhead motions
- weak muscles
- natural deformity of the shoulder socket
- strenuous training
- weakness of the muscles
- improper posture
- formation of bone spurs
People who play certain sports (such as tennis, swimming, baseball, etc) or perform other occupational activities (such as moving boxes, painting, and construction work) that demand using shoulders for overhead or forceful motion are prone to experiencing shoulder impingement. Similarly, older people and those with a previous shoulder injury such as a dislocation of the shoulder socket are also at a higher risk of developing shoulder impingement.
What Is The Treatment?
Depending on the condition of the rotator cuff tendon and the severity of the associated symptoms, your GP may advise an appropriate treatment plan. If diagnosed early, shoulder impingement syndrome can be treated easily by avoiding overhead or painful activities, placing an ice pack on the affected shoulder, or taking OTC painkillers. If things do not get better, the following treatment options can be tried on the advice of a registered GP.
The most effective treatment option for shoulder impingement is physical therapy. Experienced myotherapists or physiotherapists can suggest appropriate exercises and manual therapy to strengthen shoulder muscles, improve shoulder posture and range of motion. About 2/3 of the patients are able to feel considerable relief after the first few myotherapy sessions.
If you don’t find relief with physical therapy, your GP may advise some analgesic/anti-inflammatory medications (such as ibuprofen or naproxen) to take care of the pain and the swelling. If these medications fail to produce the desired results, your GP may resort to prescribing steroid injections to curb the pain and swelling.
If all the above mentioned non-surgical treatments fail to bring any improvement in the condition, surgical intervention may the option of the last resort. Surgery (called subacromial decompression) involves removing the torn tissue that is irritating the rotator cuff or widening the space around it so that it does not rub on any part.
It is important to note that most shoulder impingement cases take about 3-6 months to heal completely and if the condition is severe, it may take up to a year to see full healing and recovery.
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