Motions such as reaching up behind the back and reaching up overhead to put on a coat or blouse, for example, increase pain. The typical symptoms of impingement syndrome include difficulty reaching up behind the back, pain with overhead use of the arm and weakness of shoulder muscles. If these muscles are injured for a long period of time, the muscle can actually tear in two, resulting in a rotator cuff tear. This causes significant weakness and may cause inability to elevate the arm. Some people will have rupture of their biceps muscle as part of this continuing impingement process.
Diagnosis begins with a medical history and physical examination.
X-rays are helpful to rule out arthritis and may show changes in the bone that indicate injury of the muscle. Bone spurs or changes in the normal contour of the bone may be present. Impingement syndrome may be confirmed when an injection of a small amount of an anesthetic into the space under one of the shoulder bones relieves pain. It is important to understand that the condition and not just the symptoms should be treated. Oral anti-inflammatory medications, such as aspirin, naproxen or ibuprofen, remain the most common treatment for this condition.