Shoulder Impingement Syndrome is a condition where the rotator cuff and the shoulder blade are compressed or pinched, causing severe shoulder pain. Athletes, industrial workers, and caregivers often complain of this condition. It is caused by one or more problems that occur together. These problems can be bursitis, tendinitis, calcific tendinitis, degenerative joint disease, and acromioclavicular joint arthritis.

The symptoms of this condition are initially minor pain and a slight loss of strength in the muscles. Later on, shoulder movement restriction and severe pain above the shoulder joint become more evident. In bursitis, there is moderate to severe pain and movement limitation. In tendinitis, there is a sharp pain in specific positions. Repetitive tendinitis attacks can lead to rotator cuff tears.

The pain associated with shoulder impingement syndrome is felt in the front and side of the upper arm, and it may worsen at night. The movement limitation of the shoulder is visible when trying to lift the arm forward or to the side. Also, there is difficulty in moving the arm inward, bringing it to the back, and lifting and lowering heavy objects.

To diagnose this condition, direct radiographs (AP, scapula Y, axillary), MRIs, and local anesthetic tests called “impingement tests” are used. In the impingement test, a local anesthetic is injected into the space between the shoulder blade and the shoulder joint. If the pain subsides, but the movement does not increase, a tendon tear is suspected. If there is no pain relief, either there is no impingement or the injection was in the wrong area.

Initial treatment involves rest, ice application, anti-inflammatory medication, corticosteroid injections, and ultrasonography to reduce swelling. Sometimes, the use of an arm sling may be necessary. Once the pain subsides, shoulder-strengthening exercises should be initiated. In tendinitis, stopping the movement that triggers the condition starts the healing process. Then, the patient can gradually begin stretching and strengthening exercises. Before exercising, it is best to apply heat, and after exercising, apply cold.