What are the symptoms of shoulder impingement?

Symptoms include pain when lifting the arm, night pain, weakness, and clicking or catching in the shoulder.

How is shoulder impingement treated?

Treatment includes physiotherapy, anti-inflammatory medication, corticosteroid injections, and in some cases arthroscopic subacromial decompression or acromioplasty.

How long does recovery take?

Most patients improve within 6–12 weeks with physiotherapy. After surgery, recovery typically takes 6–8 weeks, depending on activity level.

Who is at risk of shoulder impingement?

Athletes, manual workers, and people over 40 are more likely to develop shoulder impingement due to repetitive overhead movements and age-related tendon changes.

Shoulder Impingement: Causes, Symptoms & Treatment

Shoulder impingement is one of the most common causes of shoulder pain. It occurs when the tendons of the rotator cuff become pinched or irritated as they pass through the narrow space beneath the acromion (the top of the shoulder blade). This leads to pain with lifting, reaching, and overhead activity. Early treatment can relieve symptoms and prevent further damage.

What Is Shoulder Impingement?

The rotator cuff tendons and bursa (a cushioning sac) pass through a space beneath the acromion bone. In shoulder impingement, this space becomes narrowed due to bone spurs, inflammation, or poor movement patterns, causing the tendons to rub and become irritated.

Symptoms of Shoulder Impingement

Pain at the top or outer side of the shoulder
Pain when lifting the arm overhead or reaching behind the back
Weakness or difficulty lifting objects
Night pain when lying on the affected shoulder
Clicking or catching sensations with movement

Causes and Risk Factors

Repetitive overhead activity (tennis, swimming, weightlifting)
Occupations involving lifting or overhead work
Bone spurs or curved acromion narrowing the subacromial space
Shoulder instability or previous injury
Age-related tendon changes

How Is Shoulder Impingement Diagnosed?

Diagnosis involves a clinical examination and imaging if needed:

Physical exam: Pain with specific impingement tests (Neer, Hawkins-Kennedy)
X-ray: Detects bone spurs or acromion shape
Ultrasound/MRI: Identifies rotator cuff tears, bursitis, or tendon inflammation

Treatment Options

Non-Surgical Management

Activity modification and rest from overhead movements
Anti-inflammatory medication (NSAIDs)
Physiotherapy to strengthen the rotator cuff and improve posture
Corticosteroid injections to reduce pain and inflammation
Ice therapy and supportive taping

Surgical Treatment

Surgery is considered if pain persists after several months of non-surgical care:

Arthroscopic subacromial decompression: Keyhole surgery to remove inflamed tissue and bone spurs
Acromioplasty: Reshaping the acromion to increase space for the tendons
Often performed alongside rotator cuff repair if a tear is present

Recovery and Return to Activity

Non-surgical: Improvement typically seen in 6–12 weeks with physiotherapy
After surgery: Sling for comfort 1–2 days, physiotherapy begins immediately
Return to desk work: 1 week
Return to manual work: 4–6 weeks
Return to sport: 6–8 weeks (longer if combined with tendon repair)

Risks and Complications

Complications are uncommon but may include:

Persistent pain if other shoulder pathology is present
Stiffness or frozen shoulder
Infection (rare)
Nerve or vessel injury (rare)

When to See a Shoulder Specialist

If you have ongoing shoulder pain that limits movement, sleep, or work, and it does not improve with rest and physiotherapy, it may be time to see a shoulder surgeon. Early treatment can prevent rotator cuff tears and improve recovery.