This is the most common cause of pain in the 30 - 50 year old age group,but can occur outside this range also.
Impingement occurs when the ball of the head of humerus pinches the soft tissue between it and the arch above.
This may occur because (1) the head has went up due to loss of muscle strength holding it down (dynamic impingement), (2) the soft tissue between is larger than the space (due to swollen bursa), (3) swollen/torn rotator cuff muscle, (4) Acromio-clavicular joint arthritis (between collar bone and shoulder blade)
Conservative Treatment
Anti-inflammatory tablets. This reduces the swelling of the bursa and reduces pain so that the exercises above can be done.
Exercises to balance and strengthen the rotator cuff muscles of the shoulder
Injection of cortisone (steroids). This has the above effect but is more local and lasts for up to 6 weeks to reduce the swelling and inflammation of the soft tissues.
Operative Treatment
Arthroscopic Subacromial Decompression
Surgically removing the thickened bursal tissue, coracoacromial ligament and bone spurs.
Anti-inflammatory tablets. This reduces the swelling of the bursa and reduces pain so that the exercises above can be done.
