10 Ways to Treat Shoulder Impingement Syndrome

Shoulder pain can significantly decrease your quality of life and keep you from participating in your daily activities and beyond. Impingement syndromes are most typical with overuse, causing inflammation and dysfunction in the shoulder. Treating shoulder impingement syndrome is all about understanding the underlying issues and addressing them correctly. Below are the top ways to effectively treat your shoulder.

Shoulder Impingement Overview

1. Rest

Shoulder impingement syndrome results in inflammation and pain in the shoulder joint, particularly with overhead motions of the arm and reaching behind the back.  Thus, it’s important to allow the shoulder time to rest to reduce inflammation and properly heal without continually flaring up the problem. This means avoiding movements that flare up the painful area. Additionally, avoid prolonged positions that irritate the shoulder, such as your sleeping posture.  You may consider using a shoulder brace to prevent accidental use too. How long you will need to rest your shoulder, and what it will specifically require will depend on the severity of your injury, your normal daily activities, and other risk factors related to your health.  Use your pain as a gauge (avoid moderate to severe pain) to help you decide when you should continue resting and when you should start pushing yourself after a bout of rest. 

Best Sleeping Positions for Shoulder Impingement Syndrome

2. Physical Therapy

Physical therapy is your top option for addressing your shoulder pain conservatively. A physical therapist is trained to help you determine what the underlying cause of your pain is and how it relates to your daily life. Additionally, a physical therapist will do a complete assessment of your symptoms of shoulder impingement, shoulder strength, flexibility, coordination and more. With this information, they will be able to work with you to create a comprehensive program to get you back on track to your normal and pain free.

Physical Therapy for Shoulder Impingement

3. Stretches and Exercises

A thorough recovery program for shoulder impingement should always include appropriate exercises and stretches. A great and versatile tool to use for shoulder strengthening is a resistance band. Stretching should address any range of motion limitations in the shoulder itself in addition to the neck and upper back. Strengthening generally addresses the rotator cuff muscles, shoulder blades, and upper back to promote overall balance and improved posture.

Shoulder Impingement Exercises

Shoulder Impingement Stretches

4. Kinesiology Tape

K-tape is a great adjunct to shoulder treatment. Ultimately, it can be used to re-train the shoulder to move properly, especially when the injury is caused by repetitive movements. It can also be used to provide gentle support (to the rotator cuff, scapula, or even acromion) and/or postural cues to optimize shoulder healing and function all at once.

Kinesiology Tape for Shoulder Impingement

5. Massage

As with any injury, shoulder pain can lead to stiff guarded muscles throughout the shoulder, back and neck. Thus, soft tissue massage is a great way to promote relaxation and restore proper function to the shoulder. There are great home options for addressing these problem areas, such as a massage cane or a lacrosse ball set. Otherwise, a massage or physical therapist can also provide specialized massage for promoting relaxation. Additionally, they may be able to show you specific techniques for home to promote healing of injured rotator cuff tendons and bursa while addressing better postural alignment.

Massage for Shoulder Impingement

6. Acupuncture

A lot of times, shoulder pain is secondary to other bigger issues related to poor muscle coordination and posture within the entire shoulder girdle and upper back. Thus, acupuncture to address the entire upper body has the potential to promote blood flow, relaxation, and an overall sense of well being. An acupuncturist can address specific areas that will be most beneficial to you. Otherwise, a great home option is an acupressure mat to address the entire back and the back of the shoulders.

7. Hot and Cold Therapy

Heating pads and ice packs are always a great adjunct to any injury treatment, especially tendonitis of the shoulder. For the shoulder, gel packs or compression ice packs that conform specifically to the arm can help provide more specific relief. Initially, if your shoulder pain is relatively new try to stick to ice for the first 24 to 48 hours. After that, try alternating between heat and cold to optimize blood flow and pain relief.

Alternating Hot and Cold Therapy - The Ultimate Resource

8. Surgery

Surgery may be an option if conservative treatment has failed, there is a significant tear in the rotator cuff, or the injury was caused by high force trauma and is associated with other shoulder injuries (such as with sports). Typically, if a tendon in the rotator cuff is more than 50% torn and the muscles have lost significant strength and function, surgery will be recommended to repair the tear. Other issues that may be addressed with surgery include osteophyte formation (excess bone), tendon fibrosis, or other degenerative issues specific to the surrounding tissues that are causing chronic impingement. Surgery is usually done via a scope (requiring only small incisions). Recovery typically takes 12 to 24 weeks. What restrictions you will have, whether you have a brace, and other components for recovery depend on the orthopaedic surgeon, the severity of the injury, and what was repaired.

9. Anti-Inflammatory Drugs

Nonsteroidal anti-inflammatory drugs, or NSAIDs, can be a great way to get any excess inflammation and swelling under control in the shoulder. With this better managed, you can potentially tolerate other treatment options better to get you on the road to recovery quicker. You can try over the counter options like ibuprofen, naproxen, and Aleve. Otherwise, talk to your MD about stronger options. Be wary of chronic extended use of these drugs, as they can cause organ, particularly kidney, damage.

10. Cortisone Injection

Cortisone injected directly into the joint space of the shoulder can be used for immediate reductions in pain and inflammation. Similar to pain medications, this can help you get on track quicker with your treatment program, particularly for exercise and stretching. Literature reports that you can get up to four cortisone shots per year without any serious side effects. However, this is a hotly debated subject. Cortisone is anti-inflammatory and pain relieving. However, it can also compromise the tissue quality of the areas it is injected into, causing further problems down the road if the true underlying cause of the original injury is not fully addressed.

Finding a Safe and Effective Shoulder Impingement Treatment

These treatment options are a great place to start. Use pain as your guide. If your pain becomes severe or is affecting your quality of life, seek medical advice to determine your best treatment options. Your doctor may request imaging, such as x-ray or MRI, to determine if you have osteophytes, a rotator cuff tear, or bursitis. Additionally, if you experience any of the following symptoms seek medical care immediately:

• A feeling of heaviness in the arms
• Onset of tingling or numbness in the arms and/or hands
• Severe pain in the shoulders and neck
• Loss of strength in the upper body
• Significant changes in your balance

When you experience shoulder pain, quickly addressing it with the right treatment options can make a world of difference. With adequate understanding and immediate attention to your shoulder pain, you can recover quickly and take steps to prevent further flares. Remember to always consult with your doctor before starting any type of treatment regimen.

Sources:

https://physioworks.com.au/injuries-conditions-1/rotator-cuff-injuries

https://www.physio-pedia.com/Subacromial_Pain_Syndrome

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