The shoulder comprising three bones - upper arm bone, shoulder blade, and collarbone, has several joints conjoined with muscles and tendons. The rotator cuff tendon connects the shoulder blade to the arm bone by running through a narrow space. However, if the tendon traps in this space, it repeatedly rubs against the shoulder blade, causing pain while raising arms over the head. Tasks such as painting, lifting, swimming, tennis, and other overhead sports that require repetitive movements are possible risk factors for developing Impingement Syndrome.
Causes Of Impingement Syndrome
Most of the time, Impingement Syndrome occurs for no recognized cause. However, factors that enhance the risk of occurrence or recurrence of the syndrome are as follows:
- Injury
- Aging
- Bone spurs or bony growths growing from the shoulder-blades
- The build-up of calcium deposits within the rotator cuff tendon
- Poor shoulder-blade posture
Common Signs and Symptoms
The common symptoms of Impingement Syndrome are as follows:
- Pain while raising arms to shoulder height
- Difficulty in reaching behind the back
- The inclination of shoulder muscles
Specialist For Impingement Shoulder Syndrome
Patients suffering from Impingement Syndrome should be referred to an Orthopedic.
Diagnosis
The specialist will carry out the following diagnosis to assess the condition:
History
The doctor will analyze the symptoms, medical history, and overall health condition of the patient.
Physical Examination
This involves physically examining the shoulder by raising the patient's arm to the side, with the palm facing away from the body. This posture is usually painful for patients suffering from Impingement Syndrome.
Laboratory Tests
X-Rays show Bone spur and other changes in the bone due to injury of muscles. X-Rays also rule out Arthritis and other reasons for shoulder pain.
Treatment Modalities Available for Management of the Disorder
Self-care measures, anti-inflammatory drugs, and physiotherapy remain the most common treatment options for Impingement Syndrome. Non-surgical treatments include the following:
- Painkillers and corticosteroid injections to help in relieving pain
- Avoiding overhead arm movements and repetitive activities
- Holding an ice pack to the shoulder for 15-20 minutes several times a day alleviates the pain
- Physiotherapy and exercises for shoulder-blade muscles as advised by the therapist
- Daily stretching in a warm shower
In most cases, the condition settles down after undergoing extensive therapy and medication. However, if non-surgical options fail, and symptoms persist, then the doctor may recommend surgery. Arthroscopy or keyhole surgery repairs the damages that occur in the tendons and widens the space under the roof of the shoulder to avoid rubbing the tendon against the bone.
Known Complications
If left untreated, Impingement Syndrome can lead to other severe conditions, such as Rotator Cuff Tears, Tendinitis (inflammation of rotator cuff tendons), and Bursitis (inflammation & swelling of bursa). Other complications include Upset Stomach, Vomiting, & Indigestion because of oral anti-inflammatory drugs. Cortisone Pills may cause side effects, such as Elevated Blood Sugar, Weight Gain, and Thinning of Skin.
Read: Shoulder Bursitis - Inflammation of the Bursa
Precautions
Patients should undertake the following precautions:
- Avoid overhead and repetitive movements with the symptomatic shoulder
- Provide rest to the shoulder but total inactivity will worsen the condition
- Try to avoid injuries as they may aggravate the problem or lead to the recurrence
- Strictly follow the stretching exercises regime as directed by the therapist
Dietary and Physical Activity Requirements
Patients suffering from Impingement Syndrome should avoid repetitive activities, particularly, those tasks where the elbow moves above shoulder level. Resting the tendon in the initial stages is extremely essential. However, inactivity will lead to the weakening of muscles and the stiffening of shoulders. The patient should perform exercises to reach the thumb up and behind the back, followed by other stretching exercises, as suggested by the therapist.
Prevention of the Disorder From Happening or Recurring
The key to preventing Impingement Syndrome is regular exercise with a focus on training rotator cuff muscles. One should also try to avoid injuries as they may lead to the recurrence of the disorder.
Support & Help
Impingement Syndrome makes it difficult for patients to carry out daily life tasks, such as reaching up overhead to wear a blouse or coat, and several other simple activities. Caregivers should provide support and assistance in such conditions and help the patient to cope with pain and discomfort.
Also Read: Shoulder Impingement Exercises
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