Shoulder Impingement or Subacromial Bursitis

What is Shoulder Impingement?

Shoulder impingement is the condition of inflammation of the tendons of the shoulder joint. It is one of the most common causes of pain in the adult shoulder. The shoulder is a 'ball-and-socket' joint. A ‘ball' at the top of the upper arm bone, humerus, fits neatly into a 'socket’, called the glenoid, which is part of the shoulder blade, scapula. Shoulder impingement is also called swimmer’s shoulder, tennis shoulder, or rotator cuff tendinitis.

Causes of Shoulder Impingement

Impingement results from pressure on the rotator cuff from part of the shoulder blade (scapula) as the arm is lifted. It is more likely to occur in young and middle-aged people who engage in physical activities that require repeated overhead arm movements. The pain may be due to "bursitis" or inflammation of the bursa overlying the rotator cuff or a "tendonitis" of the cuff itself. In some circumstances, a partial tear of the rotator cuff may cause impingement pain.

Symptoms of Shoulder Impingement

Individuals with shoulder impingement may experience severe pain at rest and during activities, weakness of the arm and difficulty in raising the hand overhead.

Diagnosis of Shoulder Impingement

Diagnosis involves physical examination by the doctor, the doctor checks for the possible range of movements with the affected shoulder. X-rays and MRI scans may be ordered to see the injury and inflammation.

Treatment Options for Shoulder Impingement

Cortisone Injection Subacromial Space

Conservative Treatment Options for Shoulder Impingement

Shoulder impingement can be treated with

  • rest,
  • ice packs,
  • anti-inflammatory drugs, and
  • avoiding the activities involving the shoulder.
Physiotherapy may be advised to strengthen the muscles and steroid injections may be given if pain persists.
Cortisone Injection Subacromial Space may also be recommended in injuries that
  • cause pain and inflammation and
  • those don't require surgical treatment.
Cortisone is a corticosteroid released by the adrenal gland in response to stress and is a potent anti-inflammatory agent.
Artificial preparations containing cortisone are injected directly into the affected joint to relieve pain and reduce inflammation. The effects may last for several weeks .

Shoulder Subacromial Decompression

Surgery for Shoulder Impingement

Arthroscopic surgery is recommended if the rotator cuff tendons are torn.

Shoulder Subacromial Decompression Surgery is a procedure that removes the bony spurs to increase space in the shoulder in order to reduce impingement of the shoulder.