Dr. Jonathan Ticker, shoulder specialist serving the greater Long Island, Brooklyn, Queens and NYC area, visits with countless patients each year discussing their shoulder joint pain, either acute or chronic. Since the shoulder is the most mobile joint in the body, any injury can cause joint pain, as well as stiffness, swelling and loss of mobility. A common cause of pain is shoulder impingement, caused by pinching (impingement) of the tendons of the rotator cuff. The continuous pinching leads to inflammation and other painful symptoms, often causing patients to no longer participate in sporting activities or engage in everyday movements.
Shoulder impingement is caused when a tendon within the rotator cuff becomes damaged as it glides against the bones and ligaments located in the shoulder joint. If repetitive, chronic pinching occurs, patients may also develop bone spurs under the flat bone located at the top of the shoulder blade, commonly known as the acromion. When bone spurs develop, patients experience severe impingement along with chronic, intensified shoulder joint pain.
Commonly found in athletes that perform overhead movements, such as swimmers and baseball pitchers, age, tendon irritation and subacromial bursitis are also associated with impingement of the shoulder joint.
Symptoms of Shoulder Impingement
The hallmark symptom of shoulder impingement is shoulder joint pain. The pain is most often felt over the front of the joint and the outside of the upper arm. Pain level may intensify at night in many patients, leading to a decreased sleep quality. Patients may also experience joint weakness and a sensation of shoulder grinding as the damaged tendon glides over the associated bones and ligaments.
Diagnosis of Shoulder Impingement
Patients are encouraged to contact Dr. Ticker at the first signs of weakness and shoulder joint pain over the front of the joint and outside of the upper arm. Inflammation associated with shoulder impingement often intensifies rapidly and has the possibility of masking injury symptoms. Dr. Ticker will perform a complete physical examination, as well as x-rays, in order to diagnose the condition and rule out other possible injuries. An MRI may also be obtained in certain circumstances.
Treatment of Shoulder Impingement
Non-Surgical
The initial treatment plan for shoulder impingement is a non-surgical approach for many patients. Dr. Ticker commonly prescribes a combination of rest, medications, home exercises and physical therapy to help improve inflammation and pain. If shoulder joint pain is too severe or continues with the use of anti-inflammatory medications (NSAIDs), Dr. Ticker may perform a corticosteroid injection into the subacromial bursa.
Surgical
Dr. Ticker may recommend an arthroscopic surgery designed to treat shoulder impingement if pain continues after non-surgical treatment. The arthroscopic surgery requires Dr. Ticker to carefully examine the rotator cuff structures for any tears and then to repair any tearing he may find within the joint. If present, bone spurs will also be removed during the same surgical procedure. The overall goal of shoulder impingement surgery is to smooth down the injured area and remove any bone spurs to provide patients with a pain-free range of motion.
If you are suffering from shoulder joint pain and believe the cause is shoulder impingement, please contact the Long Island, Brooklyn, Queens and NYC area orthopedic office of Dr. Jonathan Ticker.