Shoulder Impingement Syndrome

After lower back and neck pain, shoulder pain is the most common type of pain in our society. It is one of the serious health problems that can significantly affect a person's daily life and work. The most common cause of shoulder pain is shoulder impingement syndrome. This condition includes a wide range of issues, from painful conditions such as tendinitis or bursitis to serious muscle tears.

What Is Shoulder Impingement Syndrome?

The shoulder joint, one of the most mobile joints in the human body, is used actively and intensively during daily movements. The collarbone, shoulder blade, and upper arm bone make up the bone structures of the shoulder joint. When the muscles that move the arm to the side, forward, and backward become compressed between these bones and ligaments, shoulder impingement syndrome occurs.

What Are the Causes of Shoulder Impingement Syndrome?

Shoulder impingement syndrome usually occurs as a result of overuse of the shoulder joint, due to either internal causes related to the shoulder muscle tendon or external causes. In some cases, both internal and external causes may be present. External causes include congenital or acquired abnormalities of the bones in the area and calcification of the ligaments due to various reasons. Internal causes are the gradual reduction of blood flow to the tendons over time, leading to partial or complete tears.

Known and common risk factors for shoulder impingement syndrome include occupations that involve overhead activities, some sports, sudden and strenuous movements, and wear and tear on joint structures due to aging.

What Are the Symptoms of Shoulder Impingement Syndrome?

The symptoms of shoulder impingement syndrome may start suddenly or develop gradually. The following symptoms may occur:

• Pain in the upper and outer part of the shoulder
• Pain that worsens when lifting the arm above the head
• Pain or discomfort that can interfere with sleep
• Weakness in the arm
• Swelling
• Skin discoloration
• A popping or cracking sound when moving the shoulder

What Are the Risk Factors for Shoulder Impingement Syndrome?

Various factors contribute to the development of shoulder impingement syndrome due to overuse of the shoulder. These risk factors include:

• Engaging in sports,
• Frequent use of the arms in daily life,
• Falling on the shoulder,
• Anatomical abnormalities,
• Overexerting muscles during sudden movements,
• Straining while reaching for high places,

How Is Shoulder Impingement Syndrome Diagnosed?

The diagnosis of shoulder impingement syndrome begins with taking the patient’s medical history. A detailed physical examination is then conducted, during which activities that strain the shoulder, falls, sports, and impacts are examined.

Additionally, imaging methods such as ultrasound, X-ray, or MRI may be needed depending on the patient's clinical condition. Other imaging techniques and laboratory tests can also be used to rule out other causes of shoulder pain and confirm the diagnosis of shoulder impingement syndrome.

Treatment for Shoulder Impingement Syndrome

In the early stages of shoulder impingement syndrome, patients are advised to avoid strenuous movements of the arm, especially those above the head. Intermittent cold therapy, anti-inflammatory, and pain-relieving medications are also used during this period.

Steroid Applications

In cases of severe pain and significant movement limitation, steroid injections into the joint may be applied. To avoid complications such as frozen shoulder syndrome or muscle weakness, it is recommended that patients engage in exercises that do not aggravate the pain while maintaining mobility in the shoulder joint.

Physical Therapy Applications

Physical therapy is one of the critical steps in the treatment of shoulder impingement syndrome. Methods such as ultrasound, heat and cold applications, muscle-strengthening electrical stimulation, pain-relieving electrical stimulation, dry needling, manual therapy, hilterapy, and taping are used during treatment.

Exercise

Exercise is an essential part of shoulder impingement syndrome treatment. To strengthen the shoulder muscles and ensure a successful recovery, exercises should be performed regularly and correctly.

Surgical Intervention

For patients who do not respond to treatment or whose imaging reveals a complete tendon tear, surgery may be recommended. Surgical procedures for shoulder impingement syndrome can be performed arthroscopically or through open surgery.

During this operation, structures causing the impingement are corrected, and if a tendon tear is present, it is repaired. After surgery, exercises are required to strengthen the muscles around the joint and restore mobility.