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Shoulder impingement syndrome is a common issue that affects countless individuals each year, especially those who engage in repetitive overhead movements or activities. Studies show that shoulder impingement accounts for up to 44-65% of all shoulder pain complaints, highlighting its prevalence and the need for effective treatment options.

Dr. Brian Kelly, an orthopedic expert in Pennsylvania, helps patients relieve shoulder pain and restore mobility. With experience treating conditions like shoulder impingement, he offers personalized care, from non-surgical therapies to advanced arthroscopic procedures. Schedule an appointment with Dr. Kelly today to begin your recovery.

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Read on to explore the most effective treatment options for shoulder impingement and learn how to choose the right approach for your unique needs.

What Is Shoulder Impingement Syndrome? 

Shoulder Impingement and Rotator Cuff

Shoulder impingement syndrome occurs when the rotator cuff muscles, rotator cuff tendons, biceps tendon, or the bursa, a fluid-filled sac in the shoulder area, become compressed or irritated as they pass through the narrow space beneath the acromion (the bony top of the shoulder). This compression can lead to shoulder impingement pain, inflammation, and restricted movement in the shoulder joint, making everyday activities challenging.

In an obvious case, the condition is often linked to repetitive overhead motions, improper shoulder mechanics, or degenerative changes in the shoulder bone, which increase pressure on the soft tissue structures like the tendons and bursa. Over time, this can result in inflammation, internal impingement, external impingement, and reduced space for these soft tissues to move.

Shoulder Impingement Symptoms

  • Pain when lifting the arm overhead or during internal rotation and external rotation. 
  • Stiffness in the shoulder area. 
  • Reduced range of motion or difficulty with daily activities. 
  • Weakness in the injured side or the upper arm. 

Common Causes of Shoulder Impingement Symptoms

  • Overuse: Repetitive overhead activities such as swimming (swimmer’s shoulder), painting, or weightlifting. 
  • Sports injuries in young athletes involved in overhead motions like throwing or serving. 
  • Acute injury: Falling on an outstretched upper arm or directly onto the injured side of the shoulder. 
  • Poor posture: Rounded shoulders or a forward head posture that misaligns the three bones in the shoulder joint. 
  • Aging: Degeneration of tendons, biceps tendon irritation, or gradual narrowing of the shoulder space over time. 

Non-Surgical Treatments for Shoulder Impingement Syndrome

Physical Therapy for Shoulder Impingement: 

  • A physical therapist can guide exercises focused on improving the strength and mobility of the rotator cuff muscles and the soft tissue structures. Shoulder stretches, resistance band work, and rotator cuff strengthening can stabilize the shoulder joint. 
  • Ice therapy can reduce swelling in the shoulder pathology and alleviate shoulder impingement pain. 
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) or topical treatments can minimize discomfort and inflammation in the soft tissue structures. 
  • Proper posture and ergonomic adjustments in daily activities can help prevent shoulder impingement and reduce strain on the joint. 

Corticosteroid Injections:

  • Steroid injections, such as cortisone injections, provide immediate pain relief by reducing inflammation in the affected shoulder area. 
  • These can complement physical therapy, enabling a better range of motion and less pain during exercises. 
  • Often used with other treatments for long-term recovery.

Lifestyle Modifications: 

  • Avoid activities that worsen shoulder pain, like repetitive overhead movements or prolonged positions that strain the soft tissue structures. Seek treatment early, and rest the shoulder while maintaining mild activity to promote recovery within a few weeks.

Ergonomics and Posture: 

  • Improving ergonomics and maintaining proper posture can prevent shoulder impingement. Workspaces should keep shoulders relaxed, with supportive chairs and frequent breaks. Practice standing and sitting with your shoulders back and aligned to avoid putting unnecessary pressure on the shoulder bones and soft tissues. 

When Is Arthroscopic Shoulder Impingement Surgery Necessary?

Overview of Arthroscopic Procedures for Shoulder Impingement Surgery 

Arthroscopic procedures, often performed by orthopedic surgeons, involve a tiny camera (arthroscope) and specialized tools inserted through small incisions in the shoulder area. This minimally invasive approach allows surgeons to address an obvious case of shoulder pathology, such as removing bone spurs, inflamed tissue, or repairing a torn rotator cuff, all while minimizing disruption to surrounding soft tissues. These procedures are typically done under a local anesthetic for patient comfort.

Scenarios Where Non-Surgical Treatments Fail 

When non-surgical treatments, such as physical therapy, nonsteroidal anti-inflammatory drugs, and rest, don't relieve persistent shoulder impingement pain or improve mobility, surgical intervention may be necessary. Internal impingement or external impingement causing ongoing symptoms that interfere with daily life, work, or sports medicine activities like swimming can warrant surgery. 

Benefits of Minimally Invasive Surgical Techniques 

  • Smaller Incisions: Lead to less scarring and reduced infection risk, helping to relieve pain effectively. 
  • Faster Recovery: Faster healing compared to open surgery, reducing the time spent causing pain to the patient. 
  • Reduced Pain: Minimal post-operative discomfort due to less damage to soft tissue structures near the shoulder blade and upper arm bone. 
  • Improved Precision: Clear visualization of the shoulder pathology for accurate treatment, lowering shoulder impingement risk factors. 

Diagnose Shoulder Impingement

To diagnose shoulder impingement based on symptoms, doctors rely on a combination of medical history, physical exams, and imaging tests like X-rays or magnetic resonance imaging (MRI). A physical exam can pinpoint tender areas, reduced mobility, or a pinched nerve in the shoulder area, often found near the shoulder blade or upper arm bone.

MRI can reveal soft tissues, degenerative changes, or torn rotator cuffs, helping to determine whether anti-inflammatory medications or arthroscopic surgery is necessary. Understanding shoulder impingement risk factors is key to effective diagnosis and treatment.

Prevent Shoulder Impingement: Move Toward a Pain-Free Life

Minimally invasive surgical techniques offer numerous advantages, such as faster recovery, reduced pain, and improved precision, allowing patients to return to their daily lives with minimal disruption. When joint pain disrupts your quality of life, Dr. Brian Kelly is here to help.

Don’t wait to reclaim your mobility and comfort—schedule an appointment with our practice today. At Dr. Brian Kelly, we specialize in advanced orthopedic care, including shoulder impingement treatment tailored to your needs. Contact us now to start your journey to a healthier, pain-free you!

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