Shoulder impingement is a common reason for pain when you lift your arm. The term describes pain at the top and front of the shoulder, where the rotator cuff tendons pass under a bony arch. It is closely linked with rotator cuff tendinopathy. Most patients do well with conservative treatment.
What does shoulder impingement feel like?
- Pain on the outer side or front of the shoulder, sometimes spreading to the upper arm
- Pain when lifting your arm, reaching overhead or reaching behind your back
- Pain at night, especially when lying on the affected shoulder
- Weakness, or a feeling of catching as you raise the arm
What causes shoulder impingement?
Shoulder impingement occurs when the rotator cuff tendons become pinched or compressed in the narrow space beneath the acromion (the top of the shoulder blade). Common contributors include:
- Structural bone changes that reduce the subacromial space, such as a bone spur or a hooked acromion
- Repetitive overhead activities, such as frequent overhead lifting, swimming, tennis or weight lifting
- Age-related degeneration
Our page on rotator cuff tendinopathy explains the tendon changes in more detail.
How is shoulder impingement diagnosed?
The diagnosis of shoulder impingement is based on history and a physical examination. Typically, patients with shoulder impingement syndrome experience pain when the arm is raised sideways between 70 and 120 degrees. There are also clinical tests that can differentiate impingement from other shoulder or neck disorders. If your shoulder pain is likely to come from shoulder impingement, your doctor may order radiological investigations to confirm the diagnosis (for example, dynamic ultrasonography) and to determine if there is a structural cause (for example, MRI or X-rays).
How is shoulder impingement treated?
Most patients do well with conservative treatment. Treatment usually follows steps:
- Activity changes: reduce the movements that aggravate the pain, rather than resting the shoulder completely.
- Guided exercise, usually with a physiotherapist.
- Pain medicines, used as your doctor advises.
- For persistent pain, an ultrasound-guided injection around the tendon is useful in reducing inflammation and pain, allowing you to return to usual activities quickly.
No treatment works for everyone. We will explain the benefits, limits and risks of each option so that you can decide what suits you.
When should you see a pain specialist?
Consider an assessment if your shoulder pain has lasted more than a few weeks, keeps coming back, wakes you at night, or has not improved with rest, simple pain relief and gentle exercise. Getting the diagnosis right matters, because tendon problems, tears, frozen shoulder, arthritis and neck problems can all cause shoulder pain and may need different treatment. For an overview, read about shoulder pain in Singapore.
Seek urgent care if you have shoulder pain with chest pain, breathlessness or sweating, a hot, red and swollen shoulder with fever, or sudden loss of the ability to lift your arm after a fall or injury.
Common questions about shoulder impingement
Is shoulder impingement the same as rotator cuff tendinopathy?
No. Shoulder impingement and rotator cuff tendinopathy are not exactly the same, but they are intertwined. Shoulder impingement is the mechanical problem that causes damage to the rotator cuff tissue (rotator cuff tendinopathy). Because they frequently happen together and share similar symptoms, clinicians often group them under the broader term “rotator cuff disease”.
Can shoulder impingement be cured?
Yes. Most patients respond well to treatment.
Does shoulder impingement need surgery?
Most people are managed without surgery.
Is it impingement or a pinched nerve?
A problem in the neck can also cause shoulder pain, sometimes with tingling or numbness down the arm.
Book a consultation
If you have shoulder pain that is not settling, visit Alleviate Pain Clinic. Our shoulder pain specialist can help to find the cause and recommend treatment. Call 8655 5722 or WhatsApp us to book.
This article gives general information and is not a substitute for medical advice.
