Impingement syndrome of the shoulder

Abstract

Impingement syndrome of the shoulder is a common cause of shoulder pain. There are three types of shoulder impingement, namely, subacromial, subcoracoid, and internal impingement. They are described according to the location that impingement occurs. Each can present in isolation or combined with the others. Understanding in pathophysiology and pathomechanics of the impingement syndrome is essential in the treatment of the patient. Both static and dynamic factors play certain roles in the etiology of impingement. Clinical evaluation of the syndrome requires thorough physical examination and appropriate investigations. Goals of treatment include pain relief and restoration of the shoulder function. Any structural problems should be addressed and corrected. Moreover, associated physiologic and biomechanical factors must be treated. Nonsurgical management should be the initial mode of treatment. Surgical treatment is indicated if conservative treatment fails to improve the patient’s symptoms.