Shoulder impingement syndrome occurs when the head of the humerus impinges on the acromion, a process that can progressively lead to further friction and, ultimately, rupture of the tendons. Impingement typically takes place when the humerus is elevated above shoulder level. Scientifically, the condition is referred to as subacromial impingement syndrome and represents one of the most common causes of shoulder pain.
Etiology of Shoulder Impingement Syndrome
Shoulder impingement syndrome may develop due to various factors, the most significant of which include:
- A traumatic event, often repetitive in nature, resulting from frequent and excessive strain during athletic activities. It is commonly observed in athletes participating in swimming, tennis, volleyball, handball, and similar sports.
- Poor technique during sports activities
- Poor posture
- Weakness of the rotator cuff muscles
- Degenerative changes
- Anatomical variations
- Age, typically over 60 years
Symptoms of Shoulder Impingement Syndrome
The most commonly reported symptoms among patients with shoulder impingement syndrome include:
- Pain located at the anterior or lateral aspect of the shoulder. This pain often radiates down to the elbow or, in some cases, up toward the neck and upper back.
- Pain during sleep, particularly when lying on the affected shoulder.
- Upper limb weakness
- Restricted range of motion in the shoulder joint.
- Difficulty performing daily activities.
Diagnostic Evaluation of Shoulder Impingement Syndrome
Diagnosis of shoulder impingement syndrome is based on clinical examination and imaging studies. Clinical assessment includes specific orthopedic tests such as the Neer test and the Hawkins test, while imaging modalities such as ultrasound, X-ray, and magnetic resonance imaging (MRI) are recommended to achieve comprehensive visualization and assessment of the condition.
Management of Shoulder Impingement Syndrome
Shoulder impingement syndrome can be managed either conservatively or surgically.
- Rest and avoidance of activities that aggravate the symptoms
- Pharmacological therapy with anti-inflammatory medications
- Cryotherapy
- Physiotherapy program focused on stretching and strengthening
- Corticosteroid injections to reduce inflammation and pain
- Postural correction to alleviate mechanical stress on the shoulder joint
If conservative treatment fails to provide adequate symptom relief, surgical intervention may be considered. The preferred surgical approach is arthroscopic subacromial decompression, during which the surgeon inserts a small camera through minimal skin incisions to visualize the joint. The procedure allows for smoothing of the acromion and, when necessary, repair of torn tendons.Arthroscopy is a minimally invasive technique that generally does not require hospitalization and is associated with excellent clinical outcomes and low complication rates.
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