What is Shoulder Impingement (Impingement Syndrome)?

What is Shoulder Impingement (Impingement Syndrome)?

Table of Contents

• Which Complaints Does It Cause?
• How is Impingement Syndrome Diagnosed?

Impingement syndrome is a type of painful condition that occurs in the shoulder. It occurs when the tendons and soft tissues in the shoulder joint (rotator cuff) are pinched or compressed. This impingement can cause restriction of shoulder movements, pain and damage over time.

Impingement syndrome often develops due to repetitive shoulder movements or repetitive overload. Certain factors can contribute to the occurrence of impingement syndrome, such as disturbances in shoulder stability, abnormalities in shoulder anatomy or trauma.

Symptoms include shoulder pain, especially radiating into the arm, limitation of movement, loss of strength, difficulty sleeping on the shoulder and sometimes swelling of the shoulder. These symptoms can affect daily activities and sometimes cause sleep problems.

Impingement syndrome can be diagnosed by physical examination and imaging tests (X-ray, magnetic resonance imaging (MRI) or ultrasound). Treatment usually starts with conservative methods and may include approaches such as physical therapy, exercises, painkillers, anti-inflammatory drugs and resting the shoulder. Surgical intervention may be necessary in severe cases or in cases that do not respond to conservative treatment.

Correct body mechanics and strengthening of the shoulder muscles are important for the prevention or treatment of impingement syndrome. Also, avoiding repetitive movements or overloading can reduce the risk.

Which Complaints Does It Cause?

Impingement syndrome can lead to various complaints, such as pain, limitation of movement and dysfunction in the shoulder. These complaints may include the following:

• Shoulder pain: The most common symptom of impingement syndrome is pain in the shoulder. The pain, which is usually felt in the front or outer part of the shoulder, can worsen over time and radiate down the arm. The pain may increase, especially when you move the shoulder.
• Limitation of movement: Impingement syndrome can limit the shoulder’s range of motion. In particular, you may have difficulty with movements such as lifting the shoulder upwards, opening it sideways or pushing it backwards. 
• Loss of strength: Impingement syndrome can cause loss of strength due to the shoulder muscles being affected. This can make it difficult to perform daily activities or lift things.
• Difficulty sleeping on the shoulder: People with impingement syndrome may have difficulty sleeping on their shoulders. This can negatively affect sleep quality. 
• Swelling in the shoulder: Impingement syndrome can sometimes cause a slight swelling in the shoulder. This is usually associated with inflammation or irritation of the tissues.

If impingement syndrome is suspected, your doctor will make the correct diagnosis by performing a physical examination and imaging tests. These complaints may also indicate other shoulder problems besides impingement syndrome, so it is important to consult a specialist. 

How is Impingement Syndrome Diagnosed?

Impingement syndrome is usually diagnosed by a doctor or specialist. Below are common methods used to diagnose impingement syndrome:

• Physical examination: The doctor will listen to your complaints and examine your shoulder carefully. Shoulder range of motion, tenderness points, muscle strength and stability will be assessed. This examination aims to rule out other shoulder problems besides impingement syndrome.
• Imaging tests: The diagnosis of impingement syndrome is often supported by imaging tests.

These tests may include the following:

• X-rays: Used to evaluate the shoulder structure and bones. It is not very informative for a direct diagnosis of impingement syndrome, but can be used to rule out other causes.
• Magnetic resonance imaging (MRI): Provides detailed images of the shoulder and can help detect structural changes that can lead to impingement syndrome, such as tendon injuries, impingements or other soft tissue problems.
• Ultrasound: Can be used to detect tendon or soft tissue problems in the shoulder. It provides real-time images and can help identify areas causing pain.
• Clinical tests: Some clinical tests can be performed to diagnose impingement syndrome and identify which tendons are affected. For example, tests such as the Neer test, Hawkin’s test or Drop Arm test can be used to show the presence of impingement syndrome or damage to the rotator cuff tendons.

Your doctor will assess your complaints, perform a physical examination and order imaging tests if necessary. The combination of these methods helps to accurately diagnose impingement syndrome and helps to determine the appropriate treatment plan.