Shoulder Impingement Syndrome

by Dr. Richard Bartholomew

What is shoulder impingement?

Shoulder Impingement Syndrome is a fancy word for “pinching” of the rotator cuff muscles in the shoulder. The muscles get pinched between two bones (the humeral head and the acromion process) and this causes inflammation. Inflammation will lead to more pinching and that is what causes pain.

Shoulder Impingement Symptoms

Patients often describe the feeling as a “pinched nerve in shoulder“.  The pain is usually felt on the outside of the shoulder or arm area and can radiate to the elbow or into the neck. I usually see impingement in patients over the age of 30 and very rarely in the younger patient. Anyone can get it from sedentary patients to athletes. Reaching overhead or use of the arm in certain directions makes the pain worse. Shoulder popping or snapping in the shoulder may be felt with movement. As the shoulder impingement syndrome progresses the rotator cuff muscles weaken and may subsequently tear. This is one of the ways you can tear the rotator cuff muscles.

What are the causes of shoulder impingement?

There are multiple causes for shoulder impingement, but the most common is a bone spur or a tight ligament. These structures are usually the culprits for all of your pain. They are the ones which cause the inflammation in the rotator cuff. For something so small they can sure cause a lot of sleepless nights and overall discomfort.

Conservative Shoulder Impingement Treatment

Since a majority of the patients with impingement syndrome (and no rotator cuff tear) get better with conservative shoulder impingement treatment management, this is my initial approach to your painful shoulder. This consists of physical therapy, oral anti-inflammatory medicine and/or the use of a local anti-inflammatory injection into the shoulder. My goal is to decrease the swelling or inflammation in the rotator cuff so that it will not get “pinched”. With less inflammation, you will have less pain. As the inflammation decreases, you will also have less damage to your rotator cuff tendons.

Shoulder Impingement Surgery

For a minority of patients, shoulder impingement surgery will need to be performed to remove the offending agent (typically a bone spur) and take the pressure off of the rotator cuff. This procedure is done with an arthroscope through small incisions. An arthroscope is a small camera we use to view into small spaces. The surgery is done as a same-day procedure.

What can I expect from Shoulder Impingement Syndrome Treatment?

Every person is different and it is imperative to get the proper diagnosis so that you can start on the appropriate therapy, medicine and/or have the correct surgical procedure. The results are excellent in a great majority of the patients. Underlying medical conditions can increase the likelihood of complications we may encounter along the way.

Dr. Bartholomew, orthopedic shoulder surgeon in Michigan, specializes in the treatment for  a shoulder impingement. Call our office to schedule a consultation to diagnose your pinched nerve in shoulder at (248) 673-0500.