Question 1

What causes shoulder impingement?

Accepted Answer

Shoulder impingement occurs when the rotator cuff and surrounding bursa become irritated as they pass beneath the acromion. It is often related to inflammation, overuse, shoulder mechanics, or changes in the shape of the acromion.

Question 2

Can shoulder impingement heal without surgery?

Accepted Answer

Yes. Many cases, but not all, can be successfully treated without surgery using activity modification, anti-inflammatory treatment, physical therapy, and sometimes a cortisone injection.

Question 3

How do I know if my pain is impingement or a rotator cuff tear?

Accepted Answer

It can be very difficult to distinguish between the two based on symptoms alone. Impingement and rotator cuff tears are closely related processes, and the amount or type of pain does not always tell us which is present. Ultimately, an MRI is usually necessary to confirm whether the rotator cuff is torn.

Question 4

Do cortisone injections help shoulder impingement?

Accepted Answer

Yes. A cortisone injection can decrease inflammation and pain in the subacromial space. It can also make rehabilitation easier by allowing the shoulder to move and function with less discomfort.

Question 5

When does shoulder impingement require surgery?

Accepted Answer

Surgery is considered when symptoms continue despite appropriate nonsurgical treatment. Arthroscopic surgery is a relatively simple procedure that creates more space for the rotator cuff and addresses the inflammation and impingement around it.

Shoulder Impingement