Shoulder impingement occurs when the tendons of the rotator cuff or the bursa become compressed in the narrow space beneath the acromion (the outer edge of the shoulder blade). This compression leads to inflammation, swelling, and pain, especially during arm movement. While a complete fix takes time, certain strategies can rapidly reduce acute pain and begin restoring comfortable movement. Early intervention aims to decrease pressure on the soft tissues and gently encourage mobility without causing further irritation.
Identifying Impingement Symptoms
Shoulder impingement is characterized by a specific pattern of pain that signals tissue compression within the joint. The most telling sign is pain when lifting the arm overhead, particularly between 60 and 120 degrees of elevation. This discomfort frequently radiates from the top and outer side of the shoulder down the arm.
Pain is also triggered when reaching behind the back, such as when fastening a seatbelt or a bra. Many individuals report a dull ache that is worse at night, often making it difficult to sleep on the affected side.
Strategies for Immediate Pain Reduction
Decreasing pain involves reducing inflammation and relieving pressure on the impinged tissues. Resting the joint from aggravating activities is the first step; temporarily avoid movements that cause a sharp increase in pain. Complete immobilization is not recommended, as it can lead to stiffness.
Applying cold therapy (an ice pack wrapped in a towel) for 15 to 20 minutes several times a day helps numb the area and constrict blood vessels, thus reducing swelling. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen can manage pain and target inflammation, but consult a doctor or pharmacist beforehand. Correcting your posture also provides immediate relief by widening the subacromial space. Focusing on pulling the shoulders back and down, rather than allowing them to round forward, helps reposition the shoulder blade and upper arm bone.
Gentle Exercises to Restore Movement
Once acute pain is managed, introduce controlled, low-impact motion to improve blood flow and maintain joint health. The key principle is performing movements that do not actively engage the irritated rotator cuff tendons or elevate the arm above the point of pain.
Pendulum Swings
Pendulum swings use gravity to create passive movement. Lean forward, supporting your unaffected arm on a counter or chair, and allow the injured arm to hang straight down. Using a slight rocking motion from your hips and torso, gently swing the affected arm forward and backward, side-to-side, and finally in small circles. Keep the shoulder muscles completely relaxed, letting the arm move like a dead weight for one to two minutes at a time.
Passive Range-of-Motion Exercises
Passive range-of-motion exercises, using an object like a broomstick or dowel, help regain rotation without straining the muscles. For passive external rotation, hold the stick horizontally with both hands, keeping the elbow of the affected arm bent at a 90-degree angle and tucked at your side. Use the unaffected arm to slowly push the stick outward, gently rotating the sore arm away from the body until you feel a mild stretch, but no pain. Hold this for a few seconds before returning to the start position.
Wall Slides (Finger Walking)
Wall slides restore overhead motion while limiting muscle strain. Stand facing a wall, placing your fingertips on the surface. Slowly “walk” your fingers up the wall, raising your arm as high as possible without experiencing pain or shrugging your shoulder toward your ear. This controlled, assisted elevation allows the joint to move in a safe plane. Hold the highest comfortable position for a few seconds before walking your fingers back down.
When Self-Care is Not Enough
While many cases of shoulder impingement respond well to rest and gentle exercise, certain signs indicate the need for professional medical evaluation. Seek help if the pain is severe, constant, or makes performing simple daily tasks impossible. Intervention is also necessary if pain worsens significantly after one week of diligent self-care or persists beyond a few weeks.
Specific red flags requiring immediate attention include:
- A sudden inability to lift the arm at all, which may signal a substantial rotator cuff tear.
- Any new numbness, tingling, or weakness that travels down the arm, which could indicate nerve involvement.
A healthcare professional can provide a definitive diagnosis through a physical exam and imaging, and may recommend treatments like formal physical therapy, steroid injections, or other medical interventions.