Impingement Syndrome (cont.)
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What Are the Symptoms of Shoulder Impingement Syndrome?
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The typical symptoms of impingement syndrome include difficulty reaching up behind the back, pain with overhead use of the arm and weakness of shoulder muscles.
If these muscles are injured for a long period of time, the muscle can actually tear in two, resulting in a rotator cuff tear. This causes significant weakness and may make it difficult for the person to elevate his or her arm. Some people will have rupture of their biceps muscle as part of this continuing impingement process.
How Is Impingement Syndrome Diagnosed?
Diagnosis begins with a medical history and physical examination by your doctor. X-rays will be taken to rule out arthritis and may show changes in the bone that indicate injury of the muscle. Bone spurs or changes in the normal contour of the bone may be present. Impingement syndrome may be confirmed when an injection of a small amount of an anesthetic into the space under one of the shoulder bones relieves pain.
How Is Shoulder Impingement Syndrome Treated?
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It is important to understand that the condition and not just the symptoms require treatment. Oral anti-inflammatory medications ?such as aspirin, naproxen or ibuprofen, remain the most common treatment for this condition.
You must consistently take the medication for nearly eight weeks for it to be effective. Taking anti-inflammatory medications for a short period of time may treat the symptom of pain, but it will not treat the underlying problem and symptoms will come back. There is no specific medication for this condition and response to any given medication differs from person to person. If one anti-inflammatory medication does not help within 10 to 14 days, then another one will be given until one that provides relief is found.
In addition to taking medications, daily stretching in a warm shower will help. Work to reach your thumb up and behind your back. Avoid repetitive activities with your injured arm, particularly where the elbow would move above shoulder level. Avoid vacuuming, painting, raking leaves and washing the car.
If you have persistent symptoms, despite the use of oral anti-inflammatory medications, your doctor may consider a cortisone-type injection. Cortisone is a potent anti-inflammatory medication, which should be used only when necessary because it can result in weakening of muscles and tendons.
If symptoms persist or if significant weakness is present, then your doctor may perform an MRI or arthrogram to rule out a rotator cuff tear. If the cuff is torn, surgery may be necessary to repair it.
The vast majority of people who have impingement syndrome are successfully treated with medication, stretching exercises and temporary avoidance of repetitive overhead activity until the condition settles down.