What is shoulder impingement syndrome?

Shoulder impingement syndrome involves pain and weakness when raising the arm due to a muscle tendon “catching” in the shoulder. This involves the rotator cuff tendon which connects the muscles in the shoulder to the top part of the arm. The muscle and tendon runs through a constricted space called the subacromial space at the top of the shoulder.

When it comes to shoulder impingement syndrome, the tendon ends up trapped in this space and repeatedly scrapes against the bone above; resulting to pain that becomes worse while raising the arm over the head. The individual can also suffer from persistent ache in the shoulder and pain at night time. Shoulder impingement syndrome can start abruptly after an injury or occur gradually without any obvious cause.

Causes of shoulder impingement syndrome

The subacromial space is naturally constricted, particularly when the arm is elevated. Anything that causes further narrowing of this space can cause the tendon to become trapped. The possible causes include the following:

  • Swelling or thickening of the rotator cuff tendon
  • Bone spurs under the bony roof at the top of the subacromial space
    Shoulder impingement syndrome

    Shoulder impingement syndrome can start abruptly after an injury or occur gradually without any obvious cause.

  • Accumulation of calcium deposits inside the rotator cuff tendon
  • Inflammation of the fluid-filled sac under the rotator cuff tendon and acromion

When to seek medical care

The doctor will assess the individual if he/she has persistent shoulder pain. Shoulder impingement syndrome is diagnosed by asking questions about the symptoms and assessing the shoulder.

The individual is instructed to perform specific arm movements to determine the cause of the pain. In case the cause of the pain is unclear, the doctor might refer the individual to a specialist who will request scans of the shoulder. This is carried out to rule out other possible causes of shoulder pain.

Treatment for shoulder impingement syndrome

In case the shoulder impingement syndrome is only mild, there are measures to be considered such as the following:

  • Rest the affected tendon by avoiding overarm movements to prevent any further inflammation or damage. The doctor will instruct the individual how long to rest it and when to start exercises.
  • Apply an ice pack on the shoulder for 20 minutes at several times throughout the day to ease the pain. Do not apply ice directly on the skin. Make sure that it is wrapped in a clean cloth or towel.
  • Pain medications such as non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen can help provide short-term pain relief. Other forms of pain medications such as paracetamol can also help ease the pain. In case of severe pain, a stronger pain medication such as codeine can be prescribed.


Even though it is vital to rest the shoulder joint, the individual should not stop movement altogether. Inactivity can cause the muscles to weaken which will worsen the issue and cause the shoulder to stiffen up. Due to this, a sling is not recommended.

The doctor might refer the individual to a physiotherapist so that the right arm exercises can help stretch and strengthen the shoulder as well as improve the range of movement.


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