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Impingement Synrome

If you have noticed shoulder pain when raising your arm, you may have Impingement Syndrome.  Impingement syndrome is pinching  within the shoulder.  This common problem afflicts both the young athlete, and the older population alike.

Many bones, muscles, and tendons in your shoulder allow you to reach, swing, and lift.  There is a group of muscles and tendons (Rotator Cuff) that allows all the parts to work together.  As you raise your arm, the narrow space between the humeral head and the acromion naturally compresses.  Over time, this may cause irritation of the tendons leading to inflammation (Tendonitis), excess fluid and swelling (Bursitis), and ultimately, an impingement syndrome of the shoulder.

Pain, pinching, and stiffness when raising your arm are common symptoms.  Many patients will complain of pain in the upper arm which may radiate into the forearm, hands, and fingers.  Pain is typically worse at night, making sleeping a painful and difficult event.

Individuals with impingement syndrome are people who engage in repeated overhead movements.  These movements can result in a Repetitive Motion Injury (RMI).  An RMI occurs when a forceful action is repeated day after day without resting.  Some recreational activities which may lead to an RMI include tennis, swimming, softball and other throwing and racquet sports.  In the workplace, painting, carpentry, and construction work may be the cause.  Finally, after years of just normal use, the older individual may develop an impingement syndrome.

The diagnosis of impingement syndrome will begin with your doctor taking a history and performing a physical examination.  Pain to touch, and pain with motion and against resistance are some typical findings.

A neck evaluation and neurologic exam of the upper extremity may also be performed.  This will be followed by X-rays, and if appropriate, you may be sent for magnetic resonance imaging (MRI) of the shoulder.

Rest is the initial treatment of impingement syndrome.  Avoid activities which result in pain.  Your doctor may suggest non-steroidal anti-inflammatory medication, a cortisone injection, or both.  Pain medication (analgesics) and ice applications will get you over the acute phase, but for long term relief, physical therapy will also be prescribed.  If conservative treatment should fail, your doctor may discuss surgical options, such as arthroscopic surgery.

(Click on Arthroscopic Subacromial Decompression to see more)

Impingement syndrome is a condition of the shoulder caused by repetitive forceful motion.  This variably may lead to inflammation and swelling, resulting in pinching of the tendons and shoulder pain.  Treatment is aimed at controlling pain, reducing swelling and restoring normal pain-free motion.


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