Impingement syndrome of the shoulder

Pain in the shoulder area can have a variety of causes, a very common clinical picture is the so-called impingement syndrome of the shoulder. The term impingement comes from the English and means "to strike", it is also known as shoulder impingement syndrome. The most common main symptoms of impingement syndrome are pain when spreading the arm apart and during overhead movements, as well as pain at night. The pain usually begins gradually and can intensify due to acute overloading, e.g. during unaccustomed overhead work or a sudden fall on the arm, which can lead to a considerable restriction of movement. A medical examination and clarification are then recommended at the latest.

The cause lies in a constriction below the bony acromion, which causes tendons and the bursa located there to become trapped when the arm is lifted. Existing wear-related changes lead to increasing constriction and thus to chronic irritation.

In addition to a detailed clinical examination by the attending physician, X-rays are taken to provide an imaging assessment of the bony structures and possible calcium deposits. In addition, an ultrasound examination may also be used. If a tendon tear or rupture is suspected, magnetic resonance imaging (MRI) can be used to clarify the situation even more precisely.

Once the diagnosis has been confirmed, oral pain medication can be started using anti-inflammatory painkillers (NSAIDs). If the pain symptoms are pronounced and movement is significantly restricted, infiltration (injection below the acromion) is also an option. If the pain is resistant to treatment, surgical treatment is indicated. The procedure is performed arthroscopically (keyhole technique) without large skin incisions. The inflammatory thickened bursa is removed and by removing a few millimetres of bone from the acromion, sufficient space can be created for the tendons. Accompanying physiotherapy is required in all cases.

Dr. Fabian Gerber, Medical Director Sportclinic Zillertal