If lifting your arm brings on a sharp pain in your shoulder, you might be dealing with shoulder impingement. Many people use the terms bursitis or tendinitis to describe this problem. All three involve irritation in the small space above the upper arm bone where tissues can get pinched.
Impingement often develops from repetitive overhead activity. With the right care plan, you can reduce pain, regain function, and learn how to prevent flare-ups.
Your Quick Action Checklist
Notice key symptoms like pain with overhead reach or at night.
See a healthcare provider for a shoulder exam and any needed tests.
Protect your shoulder with active rest, better posture, and smarter movement.
Use ice, heat, and medication as directed to control pain.
Restore motion with gentle stretches, then build strength safely.
Discuss injections or surgery if symptoms persist, and maintain a long-term prevention plan.
Common Symptoms
Impingement usually feels like pain, pinching, or stiffness in the shoulder. Discomfort often increases when you reach overhead, lift, or rotate your arm. You may also feel pain when resting, especially when lying on the affected shoulder or trying to sleep.
Why It Happens
Shoulder impingement is commonly caused by repeated overhead movements. Activities that can contribute include:
Stocking high shelves
Painting or carpentry
Swimming, tennis, softball, and other overhead sports
Weekend home repair projects
Sometimes it develops after many years of normal use. Certain bone shapes or conditions can narrow the space in the shoulder and make symptoms more likely.
How Doctors Diagnose It
Your healthcare provider will examine your shoulder and may use a few simple tests to confirm a diagnosis:
Impingement Sign Test: Your provider gently raises and guides your arm, asking you to report when the movement becomes painful.
Imaging Tests: X-rays, ultrasound, or an MRI can create detailed pictures of the shoulder to show if bone shape is a contributing factor and to rule out other causes of pain.
Strength Testing: Your provider may apply light pressure while you resist with your arms in various positions to check muscle strength.
Other Targeted Tests: Additional physical maneuvers may be used to confirm impingement. Your provider will explain what each one checks.
Know Your Shoulder Basics
Your shoulder is a team of bones, muscles, ligaments, and tendons that work together so you can reach, swing, and lift. The joint forms where the humerus (upper arm bone) meets the scapula (shoulder blade). At the top of the shoulder blade are two small bony areas called the acromion and the coracoid process. Muscles and ligaments connect and stabilize these structures.
The Subacromial Space
Between the top of the humerus and the acromion is a narrow area called the subacromial space. This space contains the rotator cuff tendons and a thin, slippery sac called the bursa that cushions movement. When you raise your arm, this space becomes tighter. Irritation or swelling can crowd this area and lead to impingement.
How Impingement Starts
Impingement occurs when the subacromial space becomes too small for tissues to glide freely. Swelling from irritation makes structures take up more room, which squeezes the tendons or bursa and causes pain. Symptoms often progress gradually, so many people do not notice a problem until pain interferes with daily tasks.
Overuse and Inflammation
Constant use can irritate the bursa and the rotator cuff tendons. Your body responds by sending extra blood to help, which creates swelling. As swelling increases, two issues can develop:
Bursitis is inflammation of the bursa. The bursa fills with fluid and puffs up, leaving less room for smooth movement.
Tendinitis is inflammation of the tendons. Thickened, swollen tendons further narrow the joint space.
Bone Shape and Other Factors
The acromion can be naturally flat or more hooked. A hooked shape makes the subacromial space smaller and can increase the chance of impingement. Bone spurs, which are small bony growths, can also narrow the area. Poor posture and weak supporting muscles can add stress to the shoulder and worsen symptoms.
Start Feeling Better
Leaving impingement untreated can lead to more serious problems, such as thinning or tearing of rotator cuff tendons. Early steps like rest, activity changes, and guided exercises can calm the irritation and protect the shoulder.
Rest the Shoulder the Right Way
Rest is essential, but how you rest matters. If a movement causes pain, avoid it. Pushing through pain can slow healing. Use active rest: limit overhead motions and painful activities, yet keep the shoulder moving gently through pain-free ranges so it does not become stiff.
Improve Posture and Setup
Keep your neck, shoulders, and hips in line to reduce strain.
Check your posture when sitting, standing, and lying down. Try to sleep on your back when possible.
Fit your workstation to your body. Place your monitor at eye level and adjust surfaces so you are not leaning or reaching.
Support your lower back. Slumping places extra stress on the shoulders.
Use Your Shoulder Wisely
Small changes in how you work and move can protect the shoulder and reduce overuse.
Position Your Body
Keep frequently used items within easy reach to avoid stretching or twisting.
Avoid tasks that require your elbow to stay above shoulder height for long periods.
Use a stool or stepladder to bring yourself closer to overhead work and limit awkward reaching.
Change Tasks and Pace
Vary your activities during the day and limit time spent on any single overhead task.
Give your shoulder time to recover between higher-stress activities.
If a task brings on pain, stop, rest your shoulder, and switch to something else if possible.
Limit Force and Strain
Cut back on heavy lifting, pushing, and pulling. Ask for help or use equipment like dollies.
Choose tools that let you use the least amount of force for the job.
Rest before repeating high-force tasks. The more often you repeat a strenuous motion, the higher the injury risk.
Pain Relief Options
There are several ways to ease pain while your shoulder heals. Your provider will help you tailor a plan to your needs. Everyone responds differently, so you may need to try more than one option.
Ice
Ice reduces inflammation and calms pain. Apply an ice pack wrapped in a thin towel for 15-20 minutes, two or three times per day. Do not apply ice directly to the skin.
Heat
Heat can relax tight, aching muscles, but it does not reduce swelling. A heating pad or warm shower for 10-15 minutes works best before activity as part of a gentle warmup. Avoid heat if you have significant swelling or constant pain.
Injection Therapy
A targeted injection of anesthetic and cortisone can reduce pain and swelling, which also helps confirm the diagnosis. Your shoulder may feel sore for a day or two before the cortisone takes full effect. Talk with your provider about the risks and benefits.
Medication
Over-the-counter anti-inflammatory pain relievers may be recommended. Your provider may also prescribe medication. Follow instructions closely.
Ultrasound
Therapeutic ultrasound sends sound waves into soft tissues. The gentle warming can reduce pain and may support healing as part of a physical therapy program.
Electrical Stimulation
Mild electrical stimulation (TENS) can help ease pain and swelling. Small pads are placed on your skin to deliver a low current. You may feel a tingling sensation, but it should not be painful.
Improve Flexibility
Gentle stretching helps restore a pain-free range of motion. Breathe normally and move smoothly without forcing any movement. If your instructions from a provider differ, follow their guidance.
Broom Stretch
Stand or lie on your back. Hold a broomstick or cane with both hands.
Use your good arm to gently push the stick, raising your injured arm up as high as is comfortable.
Hold for 10-30 seconds, then return to the start.
Repeat 3 to 5 times.
Back Scratcher Stretch
Drape a towel over your good shoulder.
Reach behind your back with your injured-side hand and grab the lower end of the towel.
Gently pull up on the towel with your good arm, sliding the hand behind your back upward until you feel a stretch.
Hold for 10-30 seconds.
Repeat 3 to 5 times.
Pendulum Exercise
Lean forward slightly, supporting yourself on a table with your good arm. Let the injured arm hang down relaxed.
Gently swing the arm in small circles (20 times clockwise, 20 times counter-clockwise).
Next, swing the arm forward-and-back (20 times) and side-to-side (20 times).
Perform this routine up to three times per day.
Wall Walk Exercise
Stand about two feet away from the wall.
Raise your arm to shoulder level, fingers touching the wall.
Gently walk your fingers up the wall as high as you can without pain.
Hold for 10 seconds, then walk your fingers back down.
Repeat 3-5 times. Only perform this exercise if your healthcare provider advises.
Build Strength Safely
Strengthening improves shoulder stability and supports the joint. Warm up with stretching first. Your provider or physical therapist will advise you on the right resistance.
Internal Rotation with Band
Secure an exercise band in a doorway at elbow height.
Stand with your injured side closest to the door. Keep your elbow tucked at your side, bent at a 90-degree angle.
Gently pull the band across your body.
Slowly return to the start. Repeat 10 to 15 times.
External Rotation with Band
Secure an exercise band in a doorway at elbow height.
Stand with your uninjured side closest to the door. Keep your elbow tucked at your side, bent at a 90-degree angle.
Gently pull the band outward, away from your body.
Slowly return to the start. Repeat 10 to 15 times.
Wall Pushup
Stand an arm's length from a wall. Place your palms on the wall, shoulder-width apart.
Keeping your back straight, bend your elbows and lean in toward the wall.
Push back to the starting position.
Work up to 10 to 15 repetitions.
Side Raises
Stand with your arms down and at your sides. Hold one weight in each hand.
Keep your elbows straight with your thumbs pointing down. Lift your arms up and away from your sides. Don't lift your wrists higher than shoulder level.
Slowly lower your arms to the starting position. Repeat.
Note: Biold up to 5 to 15 lifts.
When Surgery Is Considered
Most people improve with active rest and a guided exercise program. If pain persists or function remains limited, surgery may be an option to create more space in the joint and allow pain-free motion.
Surgery for Shoulder Impingement
The goal of surgery is to perform a subacromial decompression. A swollen bursa may be removed, a tight ligament can be released, or part of the acromion may be trimmed if it is hooked or has bone spurs. Surgery is performed in one of two ways:
Arthroscopy: A surgeon uses a small camera and instruments inserted through several small incisions.
Open Surgery: A surgeon uses one larger incision to work directly inside the shoulder.
Risks and Possible Complications
Risks are similar to other surgeries and include infection, injury to nearby nerves or blood vessels, stiffness, and ongoing pain.
Before and After Surgery
Before Surgery: Follow your surgeon's instructions about which medications to stop, and when to stop eating or drinking. Arrange for an adult to drive you home.
After Surgery: You will receive medication to manage discomfort. You may go home the same day or stay overnight. Ask about self-care before you leave, including how to use a sling, take medications, and apply ice. Full recovery can take a few months.
Call your doctor if you notice any of the following:
Excessive pain, swelling, or drainage from the wound
Numbness in your fingers or hand lasting longer than 48 hours
Increased redness around an incision
Fever of 100.4°F (38°C) or higher
Quick Summary
Whether you have surgery or not, a consistent self-care program protects your shoulder. Keep up with your stretches and strengthening exercises as directed by your healthcare provider or physical therapist. As symptoms improve, you can return to your usual routine with more comfort and confidence.
Have Questions?
If you have any questions or concerns, please contact one of our offices. This information is provided solely for educational purposes and is not a substitute for personalized medical advice. For detailed advice please contact us at (609) 924-8131, text us at (609) 757-9992 or send us a message via our contact form.
