Orthopedics

OSPI offers the top orthopedic surgeons in Gilbert AZ and the East Valley. Drs. Mahoney, Macqueen, Stewart and Clouse offer minimally invasive General, Sports and Joint Replacement expertise.

Physical Therapy

Whether you are pre or post-operative, OSPI’s East Valley physical therapy team works with you on both active and passive treatments. Your will be in the best hands with our licensed physical therapists!

Chiropractic

The Gilbert chiropractors at OSPI offer a plethora of nonoperative pain relief options such as manipulations, laser therapy, physiotherapy and electrical stimulation.

Family Practice

OSPI offers comprehensive family practice services including allergy testing, BHRT, medical weight loss, aesthetics and full check ups.

Medical Weight Loss

Patients routinely experience dramatic, healthy weight loss with the customized programs at OSPI. The programs combine nutrition, exercise and prescription weight loss options.

Performance Training

OSPI’s integrated team of healthcare providers work with both amateur and professional athletes to maximize one’s performance with sport specific programs.

Pain Management

OSPI’s Board Certified, Fellowship Trained pain doctor offers both medication management and interventional procedures with exceptional outcomes!

Shoulder Impingement

FAQS on Shoulder Impingement

 

Shoulder impingement syndrome causes persistent pain preventing smooth performance of daily activities associated with your shoulder. In the long run, the condition results in chronic inflammation, bursitis, tendinitis, and tearing off of rotator cuff. With the latest advancements in medical technology, conservation pain management methods are beneficial in overcoming the pain and problems associated with the syndrome.

What is shoulder impingement?

Shoulder impingement syndrome is said to affect one if he or she suffers from pain and weakness with shoulder movement. Also known as shoulder muscle tendon catching, it indicates a “combination of painful symptoms” that clinical findings trace to compression of rotator cuff in the shoulder.

Intermittent trapping and compression is likely to cause irritation and inflammation in rotator cuff and swelling and injury to tendons and bursa, which in turn give rise to painful sensation. It may occur with or without tendonitis and bursitis.

What causes shoulder impingement?

The syndrome onsets with injury to rotator cuff tendons and the adjoining bursa. Tendons react with inflammatory response when impinged or subject to swelling.

A layer of soft tissues and a bony arch protect the rotator cuff tendons from knocks and bumps facilitating their easy smooth movement. When rotator cuff tendons trapped in the sub-acromial space due to muscle weakness and ligament laxity, swelling and inflammation occurs. This leads to pain.

If the sub-acromial space is compressed due to structural narrowing following osteoarthritis, calcification of ligaments, or growth of bony spurs, tendons feel the heat of impingement and become inflamed causing pain.

Shoulder impingement syndrome may also occur due to rotator cuff fatigue, trauma, overworking, bad training habits, and injury associated with activities, accident, or poor posture. Inactivity and tendinopathy may also cause the painful disorder.

What are the symptoms of shoulder impingement?

Shoulder impingement symptoms include:

  • pain in shoulder when raised above the arm or overhead
  • shoulder pain when lifting an object
  • pain radiates in an arc
  • shoulder soreness
  • pain radiating from top shoulder to elbow
  • pain when lying on the shoulder
  • worsening pain causing shoulder achiness even while resting
  • shoulder pain when reaching the back or the seat-belt

Who is at risk of shoulder impingement?

Athletes engaged in games that demand intense throwing, such as tennis, golf, volleyball, and baseball, face the risk of shoulder impingement. Poor training may aggravate the risk. Swimmers, weightlifters, and gymnasts along with occupations involving overuse of shoulders, such as painting, are also at increased risk of this condition.

Those already with bursitis, tendonitis, osteoarthritis, and frozen shoulder are more likely to injure rotator cuffs and diagnose with the problem.

How is shoulder impingement diagnosed?

Medical history and physical examination of the patient are key to diagnose shoulder impingement. Doctors evaluate symptoms and pain associated with shoulder movement to arrive at the nature of the problem. Orthopedists may prescribe x-ray or MRI imaging to identify structural abnormalities or injuries to the rotator cuff or tendons.

Many go for a positive “Impingement Test” using lidocaine injections used to decrease pain and increase mobility. Ultrasound scan also helps detect dynamic impingement of shoulder tendons.

What are the treatment methods available for shoulder impingement?

  • Medication

The fist-stage shoulder impingement is treated with non-steroidal anti-inflammatory drugs and pain killers. These drugs, however, are only for short-term and do not provide relief for worsening, severe pain in shoulder.

  • Surgical Intervention

Arthroscopic surgery, similar to endoscopy, is the most used surgical procedure to treat, trim, and reconstruct damaged cartilages. Other surgical options include rotator cuff repair, removal of impinging structures, and the widening of subacromial space.

However, these procedures are invasive and may not be suitable for all.

  • Conservative Treatment
  • Rest and rehabilitation
  • Ice therapy and acupuncture
  • Physical therapy and rotator cuff strengthening,
  • Cessation of painful activities
  • Posture improvements
  • Non-Operative Pain Management Injections

Patients now have the option to get semi-permanent pain relief through pain relieving injections. Administered as outpatient, these injections are minimally invasive, highly effective, and without any side effects. When used along with other conservative therapies, the effect remains long and enduring.

  • Anesthetic injections: Lidocaine and similar injections are administered at specific intervals to ensure pain relief. The anesthetic numbs the nerves and relieve pain for longer durations.
  • Corticosteroid injection: The steroid injection administered directly into the pain area, reduces swelling and inflammation and inhibits irritation in tendons. Thus, pain sensations remain subdued for longer durations allowing tendons to function smoothly for months and even years.
  • Glenohumeral joint injection: Containing anti-inflammatory medications and steroids, the injection provides nonoperatively pain relief for months at a time.
  • Hyaluronic acid injection: The newest type among pain management injections, it contains hyaluronic acid compounds, which relieves pain for months and helps cartilage formation in the rotator cuff.

References

Neer CS 2nd. Anterior acromioplasty for the chronic impingement syndrome in the shoulder: a preliminary report. J Bone Joint Surg Am. Jan 1972;54(1):41-50

Dorrestijn O, Stevens M, Winters JC, van der Meer K, Diercks RL. Conservative or surgical treatment for subacromial impingement syndrome? A systematic review. J Shoulder Elbow Surg. Jul-Aug 2009;18(4):652-60

Hawkins RJ, Kennedy JC. Impingement syndrome in athletes. Am J Sports Med. May-Jun 1980;8(3):151-8

Dogu B, Yucel SD, Sag SY, Bankaoglu M, Kuran B. Blind or Ultrasound-Guided Corticosteroid Injections and Short-Term Response in Subacromial Impingement Syndrome: A Randomized, Double-Blind, Prospective Study. Am J Phys Med Rehabil. May 2 2012

Ardic F, Kahraman Y, Kacar M, et al. Shoulder impingement syndrome: relationships between clinical, functional, and radiologic findings. Am J Phys Med Rehabil 2006; 85:53.

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