Shoulder impingement happens when the top edge of your shoulder blade (the acromion) rubs against or presses on the rotator cuff tendon just beneath it. That friction irritates the tendon, causing pain whenever you lift or move your arm. Shoulder impingement often occurs alongside two other common shoulder problems, bursitis and rotator cuff tendinitis, and our physiatrists frequently see all three occurring together.

At Long Island Spine Rehabilitation Medicine, our physiatrists have years of experience diagnosing and treating shoulder impingement without surgery. If shoulder pain has been slowing you down, our team can help you understand its cause and develop a treatment plan that fits your life. Contact us today to schedule an evaluation with one of our experienced Long Island physiatrists.

What Causes Shoulder Impingement?

Shoulder impingement usually develops gradually from repeated stress on the shoulder joint rather than from a single injury. Common contributing factors include:

  • Poor posture – Rounded shoulders and a forward head position narrow the space available for your rotator cuff tendon.
  • Repetitive overhead motion – Sports like swimming and tennis, along with jobs such as painting or construction work, place ongoing strain on the shoulder.
  • Sleeping on one side – Resting on the same shoulder night after night can compress the tendon over time.
  • Age-related changes – Bone spurs and general wear and tear can narrow the space beneath the acromion as you get older.
  • An irregular acromion shape – Some people are simply born with an acromion that curves or hooks instead of lying flat, which increases their risk.

Why Does Shoulder Impingement Get Worse Without Treatment?

Left untreated, shoulder impingement tends to feed on itself. Each time the tendon rubs against the acromion, the surrounding tissue swells a little more, which narrows the space even further and makes the next movement more likely to cause pain. Over time, this cycle can progress from mild irritation to significant tendon damage, so getting an accurate diagnosis early can help prevent the problem from becoming more serious.

What Are the Symptoms of Shoulder Impingement?

Shoulder impingement symptoms often build gradually over several weeks or months rather than appearing all at once. You may notice:

  • Pain when you raise your arm overhead or reach for something on a high shelf
  • Tenderness in the front of your shoulder that can spread down the side of your arm
  • Discomfort that worsens at night, especially when lying on the affected side
  • Pain when reaching behind your back, such as fastening a bra or reaching for a back pocket
  • Stiffness or a gradual loss of strength in your shoulder or arm

How Do Our Physiatrists Diagnose Shoulder Impingement?

Our physiatrists start every evaluation with a thorough conversation about your symptoms and a hands-on physical exam. We will check your range of motion, test your shoulder strength, and ask about the activities and movements that make your pain better or worse. This detailed history helps us tell impingement apart from other conditions that can cause similar pain, such as rotator cuff tears or shoulder arthritis.

When needed, we can order imaging such as X-rays, an MRI, or an ultrasound to closely examine the bones and soft tissues in your shoulder. In some cases, we can confirm a diagnosis by injecting a small amount of anesthetic into the space beneath the acromion. If your pain improves significantly afterward, that response helps confirm that impingement is the source of your discomfort.

What Are the Treatment Options for Shoulder Impingement?

Most cases of shoulder impingement respond well to nonsurgical care, and our physiatrists will develop a treatment plan tailored to your specific diagnosis, activity level, and goals. According to the Cleveland Clinic, healing from shoulder impingement can take anywhere from a few weeks to several months.

Starting With Conservative Care

In its early stages, shoulder impingement often improves with rest, ice, and over-the-counter anti-inflammatory medication. We will also recommend temporarily avoiding the specific motions that trigger your pain—whether that means changing your workout routine or adjusting how you perform certain tasks at work.

Building Strength Through Physical Therapy

Physical therapy is a key part of most treatment plans. A customized program can strengthen the muscles that support your rotator cuff and improve your posture. With time, this work can gradually restore your full range of motion. Consistent therapy gives you the best chance at a full, lasting recovery.

Relieving Pain With Targeted Injections

When rest and therapy are not enough on their own, corticosteroid or analgesic injections can deliver anti-inflammatory medication directly to the source of your pain. These injections can calm swelling around the tendon and give you a window of reduced pain in which to make faster progress in physical therapy.

Exploring Regenerative and Complementary Therapies

Because Long Island Spine Rehabilitation Medicine takes a holistic approach, we also offer treatments that go beyond standard care. 

  • Acupuncture can help reduce inflammation and improve blood flow to the injured area. 
  • Platelet-rich plasma, or PRP, therapy uses healing components from your own blood to support tissue repair. 
  • Pulsed electromagnetic field, or PEMF, therapy uses gentle electromagnetic waves to reduce pain and inflammation while encouraging your cells to heal more efficiently.

When Surgery Might Be Necessary

Our physiatrists are not surgeons, and we view surgery as a last resort rather than a first option. Most patients improve significantly with the nonsurgical treatments above. However, if your symptoms persist despite months of conservative care—or if imaging reveals a more serious tear—we will discuss your options honestly and help coordinate a referral for surgical evaluation.

Schedule Your Shoulder Evaluation Today

Shoulder pain that lasts more than a few days deserves a proper evaluation. The sooner our physiatrists identify the cause of your discomfort, the sooner we can start relieving it. Contact Long Island Spine Rehabilitation Medicine today to schedule an appointment at one of our five convenient offices in East Meadow, Great Neck, Lawrence, or Huntington.