Don’t shrug off shoulder pain: When to see a doctor for shoulder impingement

Shoulder pain is a common issue that many of us may face at some point in our lives, but understanding the causes and finding ways to prevent it can be the key to enjoying an active lifestyle, pain-free.

If you have a sensation in your shoulder that feels like a "pinch" or a sharp pain while reaching overhead, reaching behind your back or sleeping on your side, you may be experiencing a condition called shoulder impingement.

“Shoulder impingement is a condition that arises due to repetitive overuse or injury to the shoulder. It involves the tendons of the rotator cuff (the group of four muscles around the shoulder joint) and the bursa (a fluid-filled sac located above the rotator cuff.) These structures rub against the undersurface of the acromion (the bone on top of the shoulder.) This rubbing creates inflammation in the subacromial space, the area of your shoulder that allows for movement and leads to swelling, pain and discomfort,” said Bradley Teel, MD, an orthopedic surgeon on the medical staff at Baylor Scott & White Orthopedic Associates of Dallas – Grapevine.

You may have heard the term “swimmer’s shoulder” to describe shoulder impingement. But why are frequent swimmers at risk of this condition specifically?

“Swimmers are a good example of how shoulder impingement can develop with repetitive overuse. As swimmers reach and pull with each stroke, the rotator cuff and bursa slide along the structures in the subacromial space and any irritation quickly worsens with each repetitive motion,” said Dr. Teel.

Certain factors can make someone more susceptible to shoulder impingement. People who engage in repetitive overhead movements, such as swimmers, as well as those with poor posture, can weaken key shoulder muscles and lead to improper shoulder mechanics. In some cases, it can also be how your shoulder bone is formed.

“The shape of the acromion bone can reduce space for the rotator cuff, which makes some individuals predisposed to impingement,” he said.

If you’re living with joint pain, it can be treated with rest, ice and heat at home, as well as modifying your exercise routine. However, if you’re experiencing persistent pain in your shoulder, you should make an appointment with a healthcare provider.

What can you expect when you get to the doctor’s office with shoulder pain? “Diagnosing shoulder impingement usually involves a physical examination. X-rays help rule out other causes of shoulder pain and identify those at risk of impingement and possible rotator cuff injury due to the shape of their acromion. Also, ultrasound exams are becoming popular for evaluating the rotator cuff and detecting impingement and tears,” Dr. Teel said.

Treating shoulder impingement

The good news is that there are several effective treatment options for shoulder impingement.

“Fortunately, the majority of shoulder impingement cases will get better with non-operative treatment,” says Dr. Teel. Most people respond well to non-steroidal anti-inflammatory drugs (NSAIDs) medications such as Ibuprofen and shoulder exercises. “In severe cases, a steroid injection in the subacromial space can assist in rehabilitation. Surgery is only considered in rare instances when addressing specific factors leading to impingement is necessary,” he said.

When it comes to joint wellness and overall health, prevention is key. “Regular exercise and stretching are crucial not only for shoulder health but for overall well-being. Strengthening the muscles that support the scapula (shoulder blade) and the rotator cuff can help maintain shoulder health and reduce the risk of overuse injuries,” Dr. Teel.

For active people who regularly take part in sports, he advises keeping the rotator cuff and scapular muscles strong, stretching after workouts and staying hydrated, along with regular check-ins with your doctor.

“Regular check-ups can help detect imbalances in strength and range of motion before they become painful or lead to injuries. By addressing these issues early, you can keep your joints in optimal condition.”

Recommended exercises and stretches for healthy shoulders

While there are numerous exercises and stretches for healthy shoulders, some of Dr. Teel’s favorites include:

• Scapular shrugs: Squeeze your shoulder blades together
• Face-pulls: Use gym equipment to work your rotator cuff and scapular retractors
• Pectoralis minor stretching: Lean into a corner and stretch your chest muscles

Taking care of your shoulder health is not only important for maintaining an active lifestyle but also for your overall well-being. By understanding shoulder impingement, its causes and prevention methods, you can be on the path to a pain-free, mobile and active life.

If you’re experiencing shoulder pain, consult your primary care physician, an orthopedist or other healthcare professional for personalized guidance and treatment options.