Shoulder impingement syndrome is a common cause of shoulder pain. It occurs when there is impingement of tendons or bursa in the shoulder from bones of the shoulder. Overhead activity of the shoulder, especially repeated activity, is a risk factor for shoulder impingement syndrome. Examples include: painting, lifting, swimming, tennis, and other overhead sports. Other risk factors include bone and joint abnormalities.
With impingement syndrome, pain is persistent and affects everyday activities. Motions such as reaching up behind the back or reaching up overhead to put on a coat or blouse, for example, may cause pain.
Over time, impingement syndrome can lead to inflammation of the rotator cuff tendons (tendinitis) and bursa (bursitis). If not treated appropriately, the rotator cuff tendons can start to thin and tear.
The typical symptoms of impingement syndrome include difficulty reaching up behind the back, pain with overhead use of the arm and weakness of shoulder muscles.
If tendons are injured for a long period of time, the tendon can actually tear in two, resulting in a rotator cuff tear. This causes significant weakness and may make it difficult for the person to elevate his or her arm. Some people can have rupture of their biceps muscle as part of this continuing impingement process.
Many cases of shoulder impingement are caused by overuse. Repeated use of the shoulder can make the tendons in your shoulder swell, leading them to “catch” on your upper shoulder bone. In other cases, there’s no known cause.
Treating a humerus fracture depends on several factors, including the type of fracture and whether there are any loose bone fragments. To determine the best treatment, your doctor will start by taking an X-ray of your arm. They may also have you do some movements with your arm. This will help them determine what kind of fracture you have and whether you have any other injuries.
In many cases, proximal and mid-shaft humerus fractures don’t require surgery because the broken ends usually stay close together. This makes it easier for your humerus to heal on its own. However, you’ll still need to wear a sling, brace, or splint to keep your arm from moving and stabilize your shoulder, if needed. Occasionally, surgery is required with either plates, screws, rods, or sometimes replacement of your shoulder joint with use of a prosthesis.
Distal fractures and more severe proximal or mid-shaft fractures usually require surgery. There are two main approaches that your surgeon may use:
Pins and screws. If you have an open fracture, which involves a piece of bone sticking through your skin, surgery will be required to clean up the broken ends and they may use pins and screws and plates to hold the broken ends of your humerus in place.
Bone grafting. If some of the bone has been lost or severely crushed, your surgeon may take a piece of bone from another area of your body or a donor and add it to your humerus. In some cases, doctors can even use an artificial material to create a new piece of bone.
Regardless of whether or not you need surgery, your doctor will probably suggest following up with physical therapy. This will help you learn exercises and movements you can do to help strengthen your arm muscles and regain your range of motion.
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