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Shoulder Impingement

Find an Experienced Shoulder Surgeon in Fairbanks, Alaska

Shoulder Surgeon in Fairbanks, Alaska

Shoulder impingement is one of the more common problems we see in people with shoulder pain. Impingment refers to the actual compression or wear that is being done on the rotator cuff tendons when the arm is elevated. Raising the arm above the horizontal plane can actually cause direct pressure being placed on the rotator cuff tendon by a part of the shoulder blade called the acromion. Sometimes in the joint where the end of the collarbone meets this acromion, bone spurs and degeneration can occur. Beneath this joint is one of the tendons of the rotator cuff. Repeated elevation of the arm seen in swimming, pitching, and tennis can be prime candidates for this problem.

The rotator cuff tendons can wear away, degenerate, and become torn. There is a theory that chronic shoulder impingement can lead to rotator cuff tears in some people. Diagnosis is consistent with recreation of the pain when the arm is raised above the head. Pain at night, difficulty sleeping on the shoulder, and inability to perform certain tasks can be the clues needed for the correct diagnosis.

X-rays are helpful in diagnosing impingement syndrome as bonespurs, specific anatomical variances, and occasional MRI can be helpful. Usually a diagnosis can be made in the clinic, and a decision for treatment can be initiated.

Eliminating the repetitive overhead movements is a good first step. Temporarily avoiding these high risks behaviors can allow the inflammation to calm down. Non-steroidal anti-inflammatory medicines are excellent choices, and physical therapy exercises to strengthen the tendons are a good first step. Regaining flexibility, improving shoulder strength, and avoidance of certain activities which can make the symptoms worse should be avoided. Corticosteroid injections are still a good option, as many find this curative.

Statistically, most individuals do not need surgery, as this will heal itself. But, surgical intervention in cases that do not improve despite months of non-surgical options do quite well. The success rate is very high, and can be done with an open or arthroscopic technique. Surgery involves debriding (removing) the area of inflammation, and shaving part of the acromion to decompress the space so no further pressure can be placed on the tendons.

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