Is It Shoulder Impingement or Something More? How to Tell

If you’ve been dealing with persistent shoulder pain, especially when lifting your arm overhead, you may have heard the term shoulder impingement. It’s one of the most common causes of shoulder discomfort, but it can often be mistaken for another issue.

What is Shoulder Impingement?

Shoulder impingement occurs when the top edge of the shoulder blade (acromion) and the upper arm bone (humerus) pinch the rotator cuff, a group of muscles that sit in the small space between the two structures. Over time, this pinching leads to inflammation, pain, and a limited range of motion. If left untreated, it can worsen and cause more serious issues like rotator cuff injuries.

Why It’s Often Misdiagnosed

The shoulder is a complex joint, and several conditions can produce similar symptoms. Shoulder impingement is often mistaken for a rotator cuff tear—or, in some cases, the more specific forms of impingement, like rotator cuff tendinitis or shoulder bursitis, are overlooked.

Without a proper physical exam and diagnostic imaging, it can be difficult to pinpoint the true source of pain. That's why it’s essential to see an orthopedic specialist familiar with the full range of shoulder conditions.

Symptoms of Shoulder Impingement

Shoulder impingement is especially common in people who regularly perform overhead or repetitive arm movements, such as through sports like swimming, tennis, or baseball, or jobs that involve reaching or lifting above shoulder height. Patients with shoulder impingement often report:

• Pain when lifting or reaching the arm, especially overhead or behind your back
• Discomfort at night, particularly when lying on the affected shoulder
• Your shoulder is swollen and/or tender to the touch
• Pain that radiates from the front of the shoulder to the side of the arm

If these symptoms sound familiar and don’t improve with rest or basic home care, it’s time for a closer look.

How Shoulder Impingement Differs from Other Shoulder Conditions

Although shoulder impingement is a common diagnosis, it can be difficult to distinguish from other conditions with similar symptoms.. Here is a closer look at the subtle differences:

• Rotator cuff tear: Usually causes more pronounced weakness and may follow an injury or trauma. The tendon can partially or fully detach from the bone. Patients often struggle to lift their arms and may feel a tearing sensation or hear a popping sound at the time of injury.
• Bursitis: Involves inflammation of the bursa—a small, fluid-filled sac that cushions and reduces friction between the rotator cuff and the shoulder blade. Swelling of the bursa can often lead to shoulder impingement symptoms.

While these conditions can overlap, identifying the root cause of shoulder pain is key to choosing the most effective treatment. A thorough evaluation by a specialist can help clarify the diagnosis and determine the best course of care.

Treatment Options for Shoulder Impingement

Fortunately, most cases of shoulder impingement respond well to non-surgical treatment. Your care plan may include:

• Physical therapy: Targeted exercises are the first line of treatment. PT helps improve shoulder mechanics, strengthen the rotator cuff, and reduce pressure on irritated tissues.
• Activity modification: Avoiding repetitive overhead movements and rest can help ease symptoms and prevent further irritation.
• Anti-inflammatory medications: NSAIDs like ibuprofen may help reduce pain and swelling in the short term.
• Corticosteroid injections: For more stubborn cases, a steroid injection into the subacromial space can provide relief and help support progress in physical therapy.

If symptoms persist after several months of conservative treatment, your provider may recommend arthroscopic surgery. This usually involves removing a small portion of bone or inflamed tissue to create more space in the shoulder and relieve impingement. Surgery is typically minimally invasive, and many patients return to full activity after a structured rehabilitation plan.

When to See an Orthopedic Specialist

If shoulder pain has lasted more than a few weeks or is interfering with sleep, work, or physical activity, don’t ignore it. Early diagnosis and treatment can prevent long-term damage and help you avoid more invasive interventions.

At The Orthopedic Health Center, our team specializes in shoulder evaluation and care. Whether you’re an athlete or just trying to sleep comfortably again, we’re here to help you move better, feel better, and get back to the life you love. Schedule a consultation today and take the first step toward lasting shoulder relief.