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How to Diagnose & Treat Shoulder Impingement

Shoulder impingement is a common condition that causes pain and inflammation in the shoulder area. It can be caused by injury, overuse, or other factors. If you have shoulder impingement, your rotator cuff tendons may be too large for their bursa sacs—or fluid-filled sacs—to protect them from rubbing against bones in your shoulder joint. This can lead to increased friction and irritation of those tendons. In rare cases, the bursa sacs become inflamed, which can cause bursitis (inflammation of the bursa).

What are the symptoms of shoulder impingement?

You may feel pain in your shoulder when you lift your arm or make certain movements with it. You may also notice that the pain is worse when you sleep on your side because gravity pulls on the tendons in your shoulder area. Lifting weights does not cause shoulder impingement, but it does increase the risk for developing this condition if you have other factors contributing to it

How can we diagnose shoulder impingement?

Your doctor can diagnose shoulder impingement by taking a detailed history and performing a clinical examination in clinic. During this exam, they will check for tenderness in your shoulder area and determine if there are any structural abnormalities (such as bone spurs). You may also be asked to perform certain movements with your arm to see how much pain you feel when performing them in addition to special clinical tests.

What is the role of ultrasound in shoulder impingement?

Ultrasound is useful for detecting abnormalities in your shoulder. It can also be used to look at the tendons and ligaments that surround your shoulder joint. In some cases, your doctor may recommend performing an MRI scan in addition to ultrasound if there are concerns about a possible torn Labrum or rotator cuff tendon.

What are the treatment options for shoulder impingement?

Treatment for shoulder impingement involves reducing inflammation, providing pain relief, improving range of motion (ROM), and strengthening muscles around the shoulder region. This can include a variety of different strategies. One of the most common treatments is pain management, which involves taking over-the-counter medications, prescription drugs or injections to reduce inflammation. Your doctor may also recommend physiotherapy or exercise as part of your treatment plan to improve your symptoms. Surgery may be recommended in some cases if other treatments have not helped enough.

What are the injections used for shoulder impingement?

The most common injection used for shoulder impingement is a corticosteroid injection. Corticosteroids are anti-inflammatory medicines that can help reduce pain and swelling when injected directly into an area known as the Subacromial space.

If Corticosteroid injection does not provide adequate pain and symptom relief, keyhole surgery might be indicated (known as Arthroscopic Subacromial Decompression).

What is Arthroscopic Subacromial Decompression (ASAD)?

ASAD is an effective treatment for shoulder impingement because it can help to restore normal motion and relieve pain. It involves removing pressure on the rotator cuff tendons by relieving bony spurs that have built up around the bone of your upper arm bone (humerus). It is a minimally invasive operation that requires only small incisions in your skin. A special camera is inserted through one of the holes and instruments are passed through the others. Recovery is quick, and results are very good.

The information contained in this article is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment and should not be used in that capacity.

If you are experiencing shoulder impingement, please contact a professional to help you

About the Author: Dr. Mustafa Alnaib MBChB, MRCS, MSc, FEBOT is an orthopaedic surgeon, musculoskeletal doctor and Clinic Director at ACTIVATE Musculoskeletal Clinic in Kent.

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