Shoulder Impingement Syndrome

Shoulder impingement syndrome is a common shoulder complaint. The condition often is called bursitis or tendinitis. It is caused by an inflammation of the bursa under the tip of the shoulder, inflammation of the rotator cuff and/or an inflammation of the biceps tendon. Many patients also have some arthritis of the acromio-clavicular joint which contributes to the problem. Patients who habitually work over their head are more prone to this problem; however there are many various causes. Usually there is no history of trauma. However, in many cases it is the result of otherwise normal activity over many years which finally lead to the inflammation.

Patients experience a painful range of motion. Often there is pain while trying to hold the arm at 90 degrees or higher. Occasionally patients have pain with sleeping, especially those patients who sleep with their arm under their head and there may be pain at rest.

Treatment is staged dependent upon the severity of symptoms. Early treatment consists of simple steroidal or non-steroidal oral medications and rest. Later, the patient may need further oral or injection medications and physical therapy. In cases that are resistant to these conservative treatments, surgery may be indicated. Surgery is designed to remove bone spurs and open the space under the tip of the shoulder to allow the rotator cuff more space and less entrapment. This opens up the so called outlet. (see the shoulder anatomy)

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