Shoulder Impingement —
Causes & Treatment
Shoulder impingement is one of the most common causes of shoulder pain — and one of the most treatable.
What is Shoulder Impingement?
Shoulder impingement syndrome occurs when the rotator cuff tendons and bursa (the fluid-filled sac that cushions the tendons) become compressed and irritated as the arm is raised. This typically happens in the narrow space between the top of the humerus (arm bone) and the acromion (the bony prominence at the top of the shoulder blade).
Impingement is extremely common — especially in patients who perform repetitive overhead activity such as swimming, tennis, painting, or overhead lifting. It is also a common cause of shoulder pain in middle-aged and older adults.
Symptoms
- Pain when raising the arm overhead or reaching across the body
- A painful arc of motion — typically between 60 and 120 degrees of arm elevation
- Weakness with overhead activity
- Pain at rest that worsens with lying on the affected side
- Swelling or tenderness at the front of the shoulder
- Gradual onset with no specific injury event
Treatment
The vast majority of shoulder impingement cases resolve with non-surgical treatment. Physical therapy — focusing on rotator cuff strengthening, periscapular muscle training, and posture correction — is the cornerstone of treatment. NSAIDs help with inflammation, and a cortisone injection into the bursa can provide significant short-term relief.
When 3–6 months of conservative treatment fails, arthroscopic surgery (subacromial decompression) can create more space for the rotator cuff by removing inflamed bursa and any bone spurs on the acromion. This is a minimally invasive outpatient procedure with excellent outcomes.
Shoulder pain with overhead activity?
Impingement is highly treatable. Most patients get relief without surgery.