What is shoulder impingement (shoulder joint inflammation)?
"The shoulders don't move upward," "Hands can't move backward," "Getting undressed is painful." These symptoms, which are common after middle age, may be called "shoulder and shoulder joint inflammation" or "shoulder arthritis."
Shoulder joint inflammation is a general term for the condition in which inflammation occurs in the shoulder joint and causes pain and difficulty in movement. Shoulder pain is the most common type of this condition; it is also sometimes referred to as frozen shoulder or adhesive joint inflammation. It mainly occurs in middle-aged adults and diabetes, thyroid disease, and smoking are thought to be risk factors. It is estimated to affect 2 to 5% of the population and is not a rare disease.
Symptoms vary depending on the time of day.
| Time | Approximate duration | Main Symptoms |
|---|---|---|
| Inflammatory phase (acute phase) | 2 to 9 months | Severe pain, pain at night, pain even when at rest, and pain when moving |
| Regression period (chronic period) | 4 to 12 months | The pain is somewhat relieved, but the difficulty in moving is noticeable. |
| convalescence | 5 to 24 months | The movement is gradually returning, and the pain is also becoming less severe. |
These are often diseases that heal naturally, but some may persist for more than two years, and approximately half of the patients report remaining discomfort or mild pain.
In such cases, seek medical attention.
- The shoulders don't rise, and the hands can't move back.
- Showering, taking off and putting on clothes, and bending over are painful
- At night, I wake up with pain in my shoulders.
- They are watching it to see if it will get better someday, but it’s not getting any better.
Tests performed at our clinic
During the examination and consultation, we will check for pain when pressing the shoulder and the range of motion of the shoulder. It is important to determine whether there is another disease (such as tendon rupture, calcific tendinitis, or osteoarthritis).
- X-ray: To check for joint deformity and the presence of calcium deposits
- Ultrasound examination (echography): To confirm tendon rupture and synovial membrane inflammation on the spot
- MRI examination: We will recommend collaborating medical institutions if necessary.
The difference between tendon injury and tendon rupture
Pain in the shoulders and difficulty in moving can also be caused by tendon injuries (rupture of the tendon). Since the symptoms are similar, we use ultrasound tests to check the tendon condition and distinguish between shoulder and elbow pain.
medical treatment
Non-surgical treatment (conservative therapy) is the basic approach. We choose the treatment based on the stage of the disease.
- Inflammatory phaseWe will administer pain relievers by mouth, apply bandages, and inject the shoulder joint (steroids or hyaluronic acid). We will not force the shoulder to move and use a triangular towel as needed. When sleeping, we will also teach you how to position yourself so that the pain is relieved at night by placing a cushion under the shoulder. Once the pain has subsided and you can move your shoulder freely, it is important to start physical therapy as soon as possible.
- Contraction periodUnder the guidance of a physical therapist, we perform light stretching exercises such as pendulum movements, exercises to restore joint movement, and muscle-strengthening exercises around the shoulder blades. We also use warm-up therapy to relieve muscle stiffness.
- convalescenceThrough active rehabilitation, we restore the function of the joints and recommend exercise habits to prevent recurrence to suit your lifestyle and work.
Doctors who treat this disease
The surgery is performed by a plastic surgeon. Our hospital has a plastic surgery specialist from the Japanese Society of Plastic and Reconstructive Surgery on staff.
Frequently asked questions
Q. Will it get better if I leave it alone?
Although these are often illnesses that resolve naturally, some patients have reported that they have been persistent for more than two years, and about half of them still experience difficulty moving and mild pain. We recommend treatment and rehabilitation tailored to the individual situation.
Q. Is it better not to move when it hurts?
A. Try to avoid overexertion during the painful period. Once the pain subsides and you can move more freely, it is important to start physical therapy as soon as possible.
Q. When do you inject?
A. During periods of severe pain, steroids or hyaluronic acid may be injected into the shoulder joint.
Q. Does having diabetes affect it?
A. Diabetes and thyroid disease are thought to be risk factors for shoulder and elbow pain. We also provide treatment for these conditions in our internal medicine department.