What's on this Page
How does the impingement syndrome present clinically?
• Pain with active shoulder movement (patient moves arm), especially flexion (between 60 and 120 degrees), abduction and internal rotation.
• Much less or no pain with passive movement (examiner moves arm).
• Absence of swelling, redness, or warmth at shoulder joint.
• Radiographically, the space between the humeral head and inferior surface of the acromion may be <8 mm.
Individuals will often present with complaints of pain upon lifting the arm or with lying on the affected side.
They may report loss of motion as the primary reason they come in to be evaluated, or that nighttime pain prevents them from sleeping. Weakness and stiffness often result secondary to the pain.
Onset is usually gradual or insidious, typically developing over weeks to months, and patients are often unable to describe a direct trauma or inciting event that resulted in the pain.
Pain is commonly described as being located over the lateral acromion, frequently with radiation to the lateral mid-humerus.
Clinicians should attempt to obtain details regarding the nature of the shoulder pain, such as onset, quality, exacerbating, and remitting factors, and interventions attempted thus far with clinical response and history of prior injuries to the affected extremity.
Special attention should be made by the clinician to inquire about overhead activities and repetitive activities. Relief may be noted with rest, anti-inflammatory medications, and ice, but symptoms often recur upon return to activity.
Sources
1.Creech JA, Silver S. Shoulder Impingement Syndrome. [Updated 2023 Apr 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2025 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK554518/
