Patient education: Shoulder impingement (The Basics)

What is shoulder impingement? — Shoulder impingement is a condition that causes pain in the shoulder. It happens when a muscle, tendon, or bursa in the shoulder gets squeezed between the bones that make up the shoulder. A tendon is a strong band of tissue that connects a muscle to a bone. A bursa is a small fluid-filled sac that sits near a bone.

People can get shoulder impingement if they do a lot of work or a sport that involves stretching or lifting the arms overhead.

Shoulder impingement can lead to other problems, such as bursitis, which is when a bursa gets irritated or swollen, or rotator cuff injuries. The rotator cuff is made up of 4 shoulder muscles and their tendons.

What are the symptoms of shoulder impingement? — Most people have pain in the front of the shoulder. The pain is usually worse with lifting or reaching up.

Will I need tests? — You might. Your doctor or nurse will talk with you and do an exam. They might also do an imaging test such as an X-ray or ultrasound of your shoulder. An ultrasound uses sound waves to create pictures of the inside of the body.

How is shoulder impingement treated? — In most cases, the condition will get better on its own, but it can take weeks to months. To help your shoulder get better, you can:

●Rest your shoulder – Avoid reaching up or across your chest, lifting, leaning on your elbows, or lying on your shoulder.

●Ice your shoulder – Put a cold gel pack, bag of ice, or bag of frozen vegetables on the injured area every 1 to 2 hours, for 15 minutes each time. Ice often helps after you have used your arm a lot. Put a thin towel between the ice (or other cold object) and your skin.

●Take a pain-relieving medicine – Ask your doctor or nurse about taking an over-the-counter medicine, such as acetaminophen (sample brand name: Tylenol), ibuprofen (sample brand names: Advil, Motrin), or naproxen (sample brand names: Aleve, Naprosyn).

Is there anything I can do on my own to feel better? — Yes. Different exercises can help your shoulder get better. It's important to work with an expert to learn which exercises to do and how to do them the right way. This usually involves seeing an exercise expert such as a physical therapist or athletic trainer.

To keep your shoulder from getting too stiff, you can do an exercise called the pendulum swing. To do this exercise, let your arm relax and hang down while you sit or stand. Move your arm back and forth, then side to side, and then around in small circles in both directions (figure 1). Try to do this exercise for 5 minutes, 1 or 2 times a day.

Other types of exercises can help make the shoulder muscles stronger. Your physical therapist can show you how to do these types of exercises. They will tell you when to start them and how often to do them.

When you do shoulder exercises, it's important to:

●Warm up your shoulder first. You can do this by taking a hot shower or bath, or just using warm moist towels or a heating pad.

●Start slowly and make the exercises harder over time

●Know that some soreness is normal. If you have sharp or tearing pain, stop what you're doing and let your doctor or nurse know.

Some doctors might try something called "kinesiology tape." This involves putting a special type of stretchy tape on certain parts of your shoulder. The tape is meant to support the shoulder and relieve pain. There is not a lot of good evidence that this works, but some people feel that it helps.

What if my symptoms don't get better? — Usually, doctors suggest trying physical therapy (exercise) for at least 3 months. If your symptoms don't get better after this, your doctor might suggest another treatment, such as getting a shot of medicine into your shoulder. This sometimes helps relieve pain for a short time.

If your doctor thinks you might have a tear or another type of shoulder injury, they might refer you to a surgeon. But in most cases, surgery does not work well in people who just have shoulder impingement without another injury.

More on this topic

Patient education: Rotator cuff injury (The Basics)
Patient education: Bursitis (The Basics)
Patient education: Frozen shoulder (The Basics)
Patient education: Nonsteroidal antiinflammatory drugs (NSAIDs) (The Basics)

Patient education: Shoulder impingement syndrome (Beyond the Basics)
Patient education: Rotator cuff tendinitis and tear (Beyond the Basics)
Patient education: Bursitis (Beyond the Basics)
Patient education: Frozen shoulder (Beyond the Basics)