What are the treatment options for shoulder impingement?

Shoulder impingement, also called subacromial pain syndrome, describes pain linked to movement and loading around the space beneath the top of the shoulder. Reaching overhead, lifting or lying on the affected side may aggravate it. Several tissues can contribute, so the treatment plan should follow an examination rather than the label alone.

Begin by reducing the movements that clearly flare pain without keeping the shoulder completely still. [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/) can improve shoulder-blade control, rotator-cuff strength and mobility, then guide a graded return to lifting. A [Cortisone Injection](/treatments/non-surgical-orthopedics/cortisone-injection/) may be discussed when pain is blocking rehabilitation; its role and timing should be individualised. [Subacromial Decompression](/treatments/sports-and-arthroscopic-surgery/subacromial-decompression/) is a surgical option for selected people whose symptoms continue after appropriate non-surgical care.

Arrange review if pain persists, strength is declining, sleep is repeatedly disturbed or the shoulder cannot be raised normally. Seek prompt care after an injury causing sudden weakness or deformity, or with fever, a hot swollen joint, chest symptoms or new arm numbness.

Ask which movements to modify, what exercise progression is suitable, whether a tendon or joint problem is also present, and what benefit an injection is expected to provide. If surgery is proposed, ask what has been tried and how recovery would affect work or sport.