Shoulder Problems are Complicated: “Impingement Syndrome”

Pain and weakness in the shoulder joint is often described medically as “impingement syndrome.” This condition results when tendons of the rotator cuff are pinched as they pass between the top of the upper arm and the tip of the shoulder. A group of four muscles and bones, the “rotator cuff,” share a common tendon. “Tendonitis” of the shoulder joint is another frequently used term.

Impingement syndrome of the shoulder joint occurs when muscles and tendons don’t slide easily and normally. Tendons and bursae, fluid-filled sacs that protect the tendons, become irritated and swollen. Typical symptoms of this syndrome are pain, tenderness and the inability to move the shoulder joint fully and normally. An injury or repetitive motions over many years may result in the onset of a cycle of inflammation, swelling, and misery.

Other symptoms can include pain or weakness in raising the arm above your head or away from the side of the body; a grating or catching of muscles when you rotate or raise your arm; and inability to sleep on the affected side due to pain.

Risk factors for impingement syndrome:

* Injuries to the shoulder joint

* Age 50 or older

* Athletes engaging in activities such as tennis, swimming, baseball, and football that involve repetitive movements of arm and shoulder

* Persons who develop bone spurs or rough spots on bone that can irritate surrounding tissue and cause swelling

* Those whose bones are shaped in a manner that allows less space between the joint than the average person

Treating Impingement Syndrome:

Treatments may be as simple as taking aspirin and resting the arm, or it may ultimately involve surgery, depending on the severity of the condition. Some treatments that may be effective in resolving the condition are the following:

* Conservative care: rest the joint and use ice packs for up to 20 minutes at a time, as needed, up to three or four times a day.

* Take anti-inflammatory drugs such as aspirin or ibuprofen.

* Avoid activities that cause pain such as lifting something heavy or stretching to reach past your comfort zone.

* Physical therapy, including exercises or stretching to strengthen, preserve or extend your range of motion; faithfully perform exercises at home.

* Cortisone or steroid injections given if other approaches don’t eliminate the symptoms; some doctors give a cortisone injection early in the syndrome to reduce pain and swelling.

* Surgery, the last resort

Impingement syndrome may take many months or even a couple of years to heal. This is especially true when it is complicated by the “frozen shoulder” syndrome, where one cannot raise the arm overhead. Patience, your doctor’s guidance, physical therapy, and prescribed home exercises should help to ultimately resolve the condition.