Does a Shoulder Impingement Require Surgery?

Shoulder impingement is when the outer edge of your shoulder blade pinches the tendons in your rotator cuff, making it painful to lift, reach, and throw,

If you’re worried you’ll need surgery to relieve your pain, you’ll be happy to know surgery is a last-resort treatment for this injury. Dr. Steven E. Nolan starts with several less-invasive options to restore your shoulder to normal.

What is shoulder impingement?

Your rotator cuff is a marvel of design, featuring four muscles and their supporting tendons that surround your shoulder. The cuff holds your humerus in place — the head of the bone sits in a socket in your scapula (shoulder blade) — allowing you to turn and rotate your shoulder.

Sometimes, swelling in your shoulder causes the cuff to enlarge, so it doesn’t fit comfortably in the joint. When this occurs, the tendons at the top of your rotator cuff become impinged (pinched) by the top outer edge of your shoulder blade. 

This pinching causes further irritation and inflammation, leading to increasing severity of symptoms, including:

• Pain that radiates from the front of your shoulder to the side of  your arm
• Sudden pain when you lift or reach
• Pain when you throw or serve a ball
• Loss of motion and strength
• Difficulty putting your arm behind your back
• Pain that gets worse at night

Overuse (repeated throwing or lifting) is the leading cause of shoulder impingement. Sports or jobs that could cause shoulder impingement include baseball, swimming, volleyball, tennis, painting, washing windows, and hanging wallpaper or drywall.

What are your treatment options?

Dr. Nolan evaluates your medical history, performs a physical exam, and may order shoulder images to diagnose your condition. If you have a shoulder impingement, he recommends one (or more) options, including:

Rest

His first recommendation is to take a break from physical activity, especially the sport, job, or activity that caused the problem. Stopping the repetitive motion will give your body time to heal.

Physical therapy

A physical therapist helps you rebuild your shoulder strength and range of motion with specific stretches and exercises. As the impingement lessons, you focus on strengthening the muscles in your rotator cuff.

Medications

Options include over-the-counter pain relievers to ease your pain and swelling. Steroid injections can also relieve the inflammation and swelling in your shoulder.

Surgery

If the less-invasive options don’t produce enough progress, Dr. Nolan can perform minimally invasive arthroscopic shoulder surgery. He removes enough bone and soft tissue so the scapula no longer pinches the tendons at the top of your rotator cuff.

If you’re experiencing symptoms of shoulder impingement, call Steven E. Nolan, MD, in Sugar Land, Texas, or use our appointment request form.