You’ve got shoulder pain. You fear it could be a pinched nerve. You feel frustrated from having your life limited by the pain. You may be unclear if a chiropractor can help.
Chiropractors see this condition often. It’s called Shoulder Impingement. It’s also known as subacromial impingement, painful arc syndrome, supraspinatus syndrome, swimmer’s shoulder, and thrower’s shoulder.
I See Shoulder Impingement in My Practice
A male patient who works in the tech industry came in recently. He commutes to San Jose and sits at a desk all day. He hasn’t been very active for several years, and has developed neck stiffness and vague achey pain across his shoulder. Over time, he’s felt sharp left shoulder pain, and soreness down his arm.
He feels pain with removing his t-shirts. At times he feels sharp pain with flexing certain muscles. He has a ‘cold’ and ‘numb’ feeling in his left pinky that’s been causing him worry for the last 1-2 weeks. He is afraid he might have a serious injury. For relief he uses heat, icy-hot, and massage.
My Experience with Shoulder Impingement
I had a similar issue last summer after spending many hours Stand Up Paddling with poor form. I was treated by my chiropractor and my Physical Therapist Jenna Weitzman over at Alliance PT. She prescribed a series of shoulder exercises that helped.
Jenna says, “With shoulder impingement, it’s really important to correct any postural deviations to remove the increased load that has often been placed on the shoulder, leading to impingement.”
What Are the Symptoms of Shoulder Impingement?
- Minor pain that is present both with activity and at rest
- Pain radiating from the front of the shoulder to the side of the arm
- Sudden pain with lifting and reaching movements
- Athletes in overhead sports may have pain when throwing or serving a ball
As the problem progresses, the symptoms increase:
- Pain at night
- Loss of strength and motion
- Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
- The shoulder may be severely tender
- All movement may be limited and painful
What’s Happening in the Body with Shoulder Impingement?
The rotator cuff is a group of muscles and tendons that we use to lift the arm up overhead. In most parts of the body, the muscles surround the bone. In the shoulder, however, the bones surround the rotator cuff muscle tendons. If you tap on the end of the shoulder you will feel this bone right under the skin.
The tendons of the rotator cuff muscles can become irritated and inflamed. This may cause local swelling and tenderness in the front of the shoulder. When these tendons get irritated and inflamed, pain, weakness and loss of movement at the shoulder often occur.
What Causes Shoulder Impingement?
- Restricted motion of the scapula (shoulder blade)
- Excessive overhead activity
- Postural syndrome
- Repetitive activity
How Do You Diagnose Shoulder Impingement?
- Ask the patient questions about their personal history, including activities and lifestyle
- Check the patient’s range of motion
- If necessary, recommend orthopedic testing
How is Shoulder Impingement Treated?
Proper treatment allows for proper motion of the scapula, upper back, and neck. This prevents rotator cuff pinching and inflammation. Strengthening the muscles around the shoulder will result in long term relief.
Non-surgical treatments include:
- Chiropractic adjustments
- Therapeutic exercises with a focus on restoring normal motion to your shoulder
- Stretching exercises to improve range of motion
- NSAID’s like Advil, Motrin and Aleve
- Steroid injections of a local anesthetic and a cortisone preparation
- Postural training
Home treatments include:
- Developing postural awareness
- Performing therapeutic exercises recommended by your chiropractor or physical therapist
- Applying heat/ice
- Temporarily avoiding provocative movements such as overhead lifting or reaching