Shoulder Impingement

Shoulder Impingement


This is one of the commonest causes of shoulder pain, especially for people between 45 to 60 years of age. In my practice, I have found that women are more commonly affected. The cause is thought to be a conflict of space between the rotator cuff (a cuff of muscle and tendon surrounding the shoulder, and responsible for rotating it) and the acromion, a part of the shoulder blade.

Some people may be born with a very sloping acromion, but more commonly it is aggravated by formation of new bone called “spurs” that dig into the tendon while movement of the shoulder.

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Typically, most people present with pain in the front and side of the arm and shoulder, especially while moving the shoulder overhead or activities like pouring water from a kettle or hanging clothes on a clothesline! Some people report difficulty in lying on the same shoulder.

 

 

 

 

 

 

Treatment

I generally follow a protocol, when I see a patient of shoulder impingement.

Going on to the next t step when some patients fail to respond. I recommend surgery only if the symptoms persist for about 6 months inspite of treatment or there is imminent danger of a torn cuff.

Step1: avoidance of activities causing pain, anti inflammatory medications and physical therapy

Step 2: injection of cortisone in the subacromial space and physical therapy

Step 3: non responders are advised arthroscopic (key hole) surgery.