Subacromial impingement (also known as shoulder impingement syndrome) is a condition characterised by painful movement of the shoulder. Pain often occurs when moving the shoulder and arm in specific directions and can be associated with weakness.
Subacromial impingement is one of the most common causes of shoulder pain. It most commonly affects people aged 30-70 and around one in five people will experience symptoms of subacromial impingement at some time in their lives. Subacromial impingement tends to cause pain that can be felt at the top of the shoulder and can spread down the arm towards the elbow, pain worse when lifting your arm to side and above your head, weakness when lifting your arm to the side.
In subacromial impingement, the rotator cuff tendons of the shoulder (which are responsible for the movement of the shoulder in different directions) become inflamed or irritated by different causes in and around the subacromial space.
The causes of subacromial impingement are not very well understood. Factors thought to contribute to the development of subacromial impingement include repetitive overuse, muscle weakness or imbalance, and the size and shape of the bony space through which the tendons pass. It is most likely that a combination of a number of these factors will result in symptoms.
If you develop severe shoulder pain following an injury you should seek medical attention sooner. If your shoulder pain has come on very quickly or is associated with you feeling unwell, especially with a fever, you should seek urgent medical attention.
Your doctor will ask you about your symptoms and examine you. On occasions, your doctor may arrange an X-Ray to assess the shoulder joint for other causes of pain. If a diagnosis of subacromial impingement is made you may be given advice regarding exercises and rest to help relieve your symptoms. You may be referred to a physiotherapist in the first instance, depending upon the local services available.
If your symptoms fail to improve despite physiotherapy input or are very severe, you may be referred to an orthopaedic surgeon. Additional hospital treatments that can be offered for subacromial impingement include injections or, very rarely, surgery to remove some of the inflamed tissue and increase the size of the space around the shoulder through which the tendons pass. It is important to remember that in most cases an almost complete recovery can be expected without requiring any form of injection or surgery.
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