What is Shoulder Impingement Syndrome?

The 3rd most common complaint we observe in orthopedic practice is shoulder pain. The most common cause of shoulder pain is shoulder impingement syndrome. 50% of patients with shoulder pain have impingement syndrome. The patient feels pain in his shoulder when he raises his arm.

The main reason is the narrowing of the subacromial space. The subacromial space consists of the distance between the coracoacromial arch and the humeral head. In impingement syndrome, the soft tissues between the roof of the shoulder and the head of the humerus are compressed. The average subacromial distance at rest is 11 mm (Normal value is 7-14 mm).

It has a wide spectrum ranging from mild and simple bursitis to tears and arthrosis. This is why it is seen frequently.

What are the Causes of Shoulder Impingement Syndrome?

Shoulder impingement syndrome occurs in most cases as an overuse injury. It may occur due to internal reasons related to the tendon of the muscle or external reasons. In some cases, these two reasons may coexist. External causes include congenital or acquired abnormalities of the bone structures in the region and calcification of the ligaments due to various reasons. . Internal causes are tears that occur due to decreased blood supply to the tendons in the area over time.

Working in occupational groups that make repetitive overhead movements (e.g. painters, construction workers), some sports (e.g. throwing sports, swimming, basketball, volleyball), sudden and challenging movements (e.g. falling) and wear and tear on joint structures due to aging. are known risk factors for impingement syndrome.

What are the Symptoms of Shoulder Impingement Syndrome?

Pain that occurs during arm movements is the most common symptom of shoulder impingement syndrome. Pain, especially during overhead activities, may become persistent over time and cause night pain. Pain may radiate from the shoulder to the front and side of the arm. Lying on the affected shoulder worsens the pain. As a result, shoulder movements may become extremely painful and limited, and the patient may be unable to perform daily living activities such as dressing and undressing, brushing teeth, and combing hair. In later periods, weakness in the shoulder and arm muscles may occur.

How is Shoulder Impingement Syndrome Diagnosed?

The diagnosis of shoulder impingement syndrome is made with a careful patient history and physical examination. During physical examination, the presence of impingement is investigated with the help of some special tests. Depending on the clinical condition of the patient, imaging methods such as x-ray and MRI (magnetic resonance) are needed. Other imaging and laboratory examinations may be performed when deemed necessary to exclude other causes that may cause pain in the shoulder area.

Treatment of Shoulder Impingement Syndrome

Treatment of impingement syndrome is mostly rest, lifestyle changes, injections and shoulder exercises. If this treatment fails or if there is a tendon rupture or mechanical disorders, the distance from the compression must be increased and the pathological tissues in this area must be removed by arthroscopic methods.