Shoulder Tendonitis and Subacromial Impingement: Causes, Symptoms, and Treatment

Shoulder Tendonitis and Subacromial Impingement: Causes, Symptoms, and Treatment

Introduction:
Shoulder tendonitis and subacromial impingement are common conditions that cause painful inflammation in the tendons and surrounding tissues of the shoulder. These conditions are often caused by overuse, occupational strain, or recreational activities such as sports or DIY projects. Additionally, a poor sleeping position can contribute to the development of these conditions. While initial treatment typically involves medical intervention, rehabilitation, injections, and rest, surgery may be necessary if conservative measures fail. In this article, we will explore the definition of subacromial impingement, its causes, symptoms, and available treatments.

Defining Subacromial Impingement:
Subacromial impingement refers to the painful inflammation of the rotator cuff tendons and surrounding tissues. The rotator cuff tendons play a crucial role in shoulder movement, including rotation and elevation. In this condition, there is pathological friction between the rotator cuff tendons and the acromion, a bony extension of the scapula. Sometimes, the acromion can change shape, becoming hooked and rubbing against the surrounding tendons, reducing the space available for movement. This is known as an aggressive acromion. The abnormal friction between the acromion and the rotator cuff tendons causes pain, especially when the arms are raised above 90 degrees.

Causes of Subacromial Impingement and Shoulder Tendonitis:
In addition to the structural changes in the acromion, several other factors contribute to the development of subacromial impingement and shoulder tendonitis. These include:

1. Inefficient muscles that lower the humerus: When the muscles responsible for lowering the humerus become ineffective, it can lead to an imbalance in shoulder movement and increase the risk of impingement.

2. Overuse and repetitive activities: Engaging in repetitive activities that require raising the arms can lead to repeated and excessive friction, causing inflammation in the tendons.

3. Poor sleeping position: Sleeping in an improper position can put strain on the shoulder and contribute to the development of tendonitis.

Symptoms and Diagnosis:
The most common symptoms of subacromial impingement and shoulder tendonitis include pain during shoulder movements, particularly when raising the arm above 90 degrees and during the descent of the arm. Many individuals also experience nocturnal and morning pain associated with these conditions. Diagnosis is primarily clinical, but standard radiographs are necessary to confirm the diagnosis.

Treatment Options:
The treatment of shoulder tendonitis and subacromial impingement involves a multi-faceted approach. Here are some common treatment options:

1. Avoiding positions that aggravate the impingement: It is essential to avoid positions and movements that exacerbate the condition, especially those involving raising the arms.

2. Anti-inflammatory medications and injections: Nonsteroidal anti-inflammatory drugs (NSAIDs) can help reduce inflammation and manage pain. In some cases, corticosteroid injections into the subacromial space may be recommended.

3. Rehabilitation: Rehabilitation plays a vital role in the recovery process. It aims to lower the shoulder and increase the subacromial space, promoting healing and reducing symptoms.

Surgical Intervention:
If the pain persists despite proper medical treatment lasting at least three months, surgical intervention may be necessary. Surgery aims to address the underlying structural issues, such as the shape of the acromion, and alleviate the impingement.

Conclusion:
Shoulder tendonitis and subacromial impingement can cause significant discomfort and limitations in daily activities. Understanding the causes, symptoms, and available treatment options is crucial for effective management. If you suspect you may have these conditions, consult with a healthcare professional for an accurate diagnosis and appropriate treatment plan.

Actionable Advice:

1. Avoid repetitive overhead activities that put strain on the shoulder.
2. Practice good sleeping posture to minimize shoulder strain.
3. If experiencing persistent shoulder pain, seek medical attention and follow the recommended treatment plan.

Sources:

• "Tendinite de l'épaule et conflit sous-acromial - Mon Épaule"
• "Point-justice"