Shoulder pain is very common in our business. Equally common is a condition known as shoulder impingement syndrome (SIS). In fact, SIS accounts for approximately 65% of all shoulder pain cases. If you are experiencing regular and persistent shoulder pain, it’s fair to ask whether it is being caused by shoulder impingement.
A Very Complex Structure
The shoulder is an extraordinarily complex structure made up of bones, muscles, and tendons. We refer to the muscles and tendons that work together to keep the shoulder joint in place as the rotator cuff. When everything between rotator cuff and bone works as it should, the shoulder functions normally and a person feels no pain. But if things get out of whack, pain is an expected symptom.
Shoulder impingement occurs when the space between the shoulder blade and rotator cuff is reduced. The space is already tight to begin with, so any reduction tends to lead to irritation, swelling, and pain.
Unfortunately, SIS is unlikely to get better on its own if a patient doesn’t commit to taking care of the affected shoulder. Sis requires joint rest at the very least. In more serious cases, physical therapy and medical interventions are necessary.
Primary Causes of SIS
Most cases of SIS are related to inflammation of either the tendons or bursa in the rotator cuff. The inflammation is usually the result of overuse. As inflammation increases, the space between bone and tissue decreases. Swollen tissue ultimately makes contact with the shoulder blade, leading to additional swelling and pain.
Another potential cause of SIS is a bone spur on one of the shoulder bones. It irritates the tissue rather than the tissue being inflamed by overuse. Though the process is essentially working in reverse, it is no less painful.
It’s worth noting that shoulder impingement is more common among people who frequently use their shoulders at work. It is a fairly common problem among certain types of athletes as well.
Signs and Symptoms of Sis
The signs and symptoms of SIS are easily recognizable. However, they are also easily confused with other conditions that cause similar pain. Pain is the most observed and persistent symptom. If shoulder pain is the result of SIS, you would probably notice several things:
- The pain is worse at night, especially when your position in bed puts additional stress on the shoulder.
- The pain increases when you attempt to raise your arm over your head or reach behind you.
- The pain increases when trying to lift heavy objects, especially when lifting over your head.
Most SIS patients report stiffness or weakness in the shoulder as well. As an untreated shoulder impingement gets worse, stiffness and weakness can also increase. So it is important to see a medical provider if you are experiencing shoulder pain that will not seem to resolve itself.
Diagnosis and Treatment
Shoulder impingement is diagnosed through a standard office visit. The doctor will ask key questions about what the pain feels like, when it’s most severe, movements that make it worse, etc. Questions are typically followed by a physical examination during which the doctor will manipulate the arm and shoulder to assess what causes additional pain. If necessary, imaging tests can confirm an SIS diagnosis.
Despite being so common, SIS isn’t something you have to live with. It can be treated in several ways. The key is early diagnosis and treatment – before things get too bad. If you are suffering from shoulder pain that will not resolve, visit us at Lone Star Pain Medicine. Shoulder impingement might be the culprit.
