Impingement syndrome

In the context of wear and tear-related conditions affecting the shoulder, for example, patients can experience excruciatingly painful limitations of movement caused by narrowing of part of the joint, which prevents the tendons and capsule structures from sliding freely. The joint becomes 'trapped'.

This condition is known as impingement syndrome. The causes can be varied: inflammation of the bursa, tendon thickening caused by fluid deposition or partial tendon tears etc.

Schematic diagram of impingement syndrome

Symptoms

Patients are no longer able to completely lift the affected arm and especially experience pain at night. They wake up if they lie on their shoulder. Thorough diagnostic procedures should be carried out to determine which of the many possible causes are behind the problem.

Clinical examination and ultrasound scans of the shoulder frequently allow a diagnosis to be established quickly. Occasionally, an MRI scan is required.

Treatment

The conservative treatment options include anti-inflammatory and pain-relieving medications, physical measures such as the application of cold and physiotherapy. If there is no significant improvement with these measures, surgical options may need to be considered. These can often be carried out through arthroscopic surgery. In this instance, inflamed tissue is removed and the sliding pathway for surrounding tendons is widened.