Shoulder Impingement Treatment Options

Many cases of shoulder impingement respond well to nonsurgical treatments designed to reduce inflammation, restore mobility, and strengthen the shoulder muscles.

Activity Modification

Avoiding or reducing activities that exacerbate symptoms is crucial in the early stages of treatment. Overhead movements, repetitive lifting, and strenuous activities that strain the shoulder joint should be minimized to prevent further irritation of the affected tendons and bursa.

Rest and Ice Therapy

Resting and icing can help reduce inflammation and pain allowing the tissues to heal.

Physical Therapy

A structured physical therapy program is one of the most effective treatments for shoulder impingement. A physical therapist will design a customized rehabilitation program that focuses on:

• Improving posture and scapular positioning to reduce strain on the shoulder joint
• Strengthening the rotator cuff and surrounding muscles to enhance shoulder stability
• Increasing flexibility through targeted stretching exercises to improve range of motion
• Correcting movement patterns to prevent recurrent impingement

Nonsteroidal anti-inflammatory drugs (NSAIDs)

NSAIDs such as ibuprofen (Advil) or naproxen (Aleve), can help reduce pain and inflammation. These medications are commonly used in the short term to ease discomfort while other treatments, such as physical therapy, work to address the root cause of the problem.

Advanced interventional therapies

• Corticosteroid injections: For more severe pain and inflammation, shoulder surgeon Dr. Kaplan may recommend a corticosteroid injection. A corticosteroid injection is made directly into the joint space to significantly reduce inflammation and pain, providing temporary relief. This is particularly beneficial for patients with persistent symptoms that interfere with daily activities. However, corticosteroid injections are used judiciously, as repeated use may weaken the tendons over time.
• Platelet-rich Plasma (PRP) Therapy: PRP therapy is a newer, natural treatment option that uses a concentrated portion of a patient’s own blood to promote healing. The injected platelets release growth factors that stimulate tissue repair and reduce inflammation. PRP can be a great alternative for people who want to avoid steroids or who are looking for a more regenerative approach to treatment.

Surgery is considered when conservative and interventional treatments fail to provide relief or if impingement has led to significant structural damage, such as a rotator cuff tear. Shoulder surgeon Dr. Danial Kaplan specializes in minimally invasive shoulder surgeries that aim to restore normal function while minimizing downtime.  However, surgery for isolated impingement is rare.  Surgical intervention for impingement is typically only considered in conjunction with other procedures when other structural issues exist, like a rotator cuff tendon tear.

Arthroscopic Subacromial Decompression (acromioplasty)

This procedure involves using a small camera (arthroscope) and tiny surgical instruments to create more space in the shoulder joint. Dr. Kaplan carefully removes bone spurs or trims part of the shoulder blade to relieve pressure on the rotator cuff tendons and remove the source of impingement. Since this is a minimally invasive procedure, recovery is typically faster, with less pain compared to open surgery.  This is often performed alongside other procedures, such as rotator cuff repair, to ensure the best possible outcome.

Rotator Cuff Repair

If shoulder impingement has led to a rotator cuff tear, surgery may be required to repair the damaged tendon. This procedure involves reattaching the torn tendon to the bone using stitches or anchors. Advances in arthroscopic shoulder surgery allow for a less invasive approach, reducing scarring and speeding up recovery.

Whether treated with nonoperative methods or surgery, rehabilitation plays a crucial role in regaining full shoulder function. Patients typically undergo a progressive rehabilitation program that includes early mobility exercises, strength training and functional training.