The phrase “shoulder impingement” is often used as an umbrella term for many different types of shoulder pain. It refers to the irritation or trapping of varying structures - musculotendonous or bursal in between the top of the humerus (arm bone) and beneath the tip of the acromion (edge of the shoulder blade. ) Its quite difficult to determine this type of pain from early frozen shoulder or even pain referred from the neck.
While you can consider visiting a physiotherapy clinic for proper diagnosis, there’s no harm asking yourself some questions to see wether you really have shoulder impingement. Here are the three simple questions you can ask yourself to clarify the matter
Any numbness/pins and needles or shooting pain to the hand?
Weird symptoms like tingling (pins and needles), shooting electrical pains to the hand and numbness rarely come from shoulder impingement. These symptoms could come from the neck or an area such as the thoracic outlet and need further investigation.
Does the pain wake me up at around 2am?
Bizarrely whilst many shoulder issues are painful to sleep on, rotator cuff tendonitis seems to consistently wake patients up at around 2am. If you’re not waking up it doesn’t meant that you don’t have impingement, but if you are it may indicate that you do!
The Arc Test
This is a simple test where the arm needs to first be in a relaxed position. Now start moving it outwards toward your head in an arc. You will need to check the angle at which you experience the pain. For instance, if you feel the pain in the mid-range which is from 60degrees to 135degrees but not before and not after, you may well have shoulder impingement.
One of the best ways to deal with shoulder impingement is by utilising a through physiotherapy assessment and treatment. Medications to reduce inflammation (NSAID’s) or injection therapy to reduced inflammation (steroids) or provoke healing (PRP) can be of use. However, correcting your mechanics and dealing with restrictions within the soft tissues and joints whilst increasing strength and stability have been found to be just as good as surgery and with a fraction of the risk and pain. Furthermore repeated use of corticoseteroids into the shoulder have been shown to reduce the strength of the tendon and increase risk of further tears.
Whilst there are occasions for surgery, a recent study actually showed that surgical decompression for shoulder impingement was no better than a sham/placebo surgery. Think carefully before going under the knife and remember….you are not your MRI!