Shoulder Impingement: Causes, Symptoms, and Treatment
Medically reviewed by Harsha Moole, MD, Internal Medicine. Last reviewed: October 23, 2026.
What kind of doctor treats Shoulder Impingement?
An orthopedic doctor, a doctor who treats bone and joint problems, usually treats shoulder impingement. A physical therapist, an exercise and movement expert, often helps too. A direct primary care or concierge doctor can be a first stop for an evaluation and can refer you to a specialist when needed.
What is shoulder impingement?
When you raise your arm, the space between the top of your shoulder and the rotator cuff tendons gets smaller. This is shoulder impingement. The rotator cuff is a group of muscles and tendons that holds the top part of your upper arm bone firmly in your shoulder socket.
The top of the shoulder blade is called the acromion. It can rub against the tendon and the bursa below it, which causes irritation and pain.
In tendinitis, the tendons become irritated and swollen from being pinched during shoulder movements. The bursa is a small, fluid-filled sac that pads the space between the rotator cuff and the bones of your shoulder. In bursitis, it swells with extra fluid, which causes pain.
Symptoms
Rotator cuff injuries commonly cause pain and tenderness in the front or side of the shoulder. Other signs can include:
- Pain and stiffness when you lift your arm and reach for things above your head.
- More pain when you reach behind your back.
- More pain when you lie on the sore shoulder.
As the problem gets worse, you may have severe pain at night that affects your sleep. You may also lose strength and motion. Basic tasks can become hard, such as getting dressed, putting on a seatbelt, or washing or brushing your hair.
Causes and who gets it
Young athletes who use their arms overhead for swimming, baseball, tennis, and volleyball are particularly at risk. People who do repetitive lifting or overhead work with the arm, such as paper hanging, construction, or painting, are also at risk. Pain may also start after a minor injury, or with no obvious cause or injury.
A large bone spur, which is an extra bump of bone, can cause impingement on the rotator cuff.
How doctors diagnose it
Your doctor will ask about your symptoms and health history, then examine your shoulder. They will ask you to move your arm in different directions, and they will test your arm strength. They may also examine your neck to make sure the pain is not caused by a pinched nerve from the neck.
An X-ray of a shoulder with rotator cuff pain is usually normal, or it may show a small bone spur. An MRI scan gives better pictures of the rotator cuff tendons and the soft tissue around them. It can show fluid or inflammation in the bursa or rotator cuff.
Treatment
The goal of treatment is to reduce pain and restore function. In most cases, the first treatment does not involve surgery. Treatments without surgery include:
- Rest and avoiding overhead activities that tend to cause your symptoms.
- NSAIDs, which are anti-inflammatory medicines such as ibuprofen, aspirin, and naproxen. They reduce pain and swelling.
- Physical therapy. A physical therapist works on restoring motion to your shoulder. Stretching exercises are very helpful.
If rest, medicines, and physical therapy do not help, a shot of numbing medicine and a steroid may help. If treatment without surgery does not relieve pain, your doctor may recommend surgery. The goal of surgery is to create more space for the rotator cuff. The surgeon may remove the inflamed part of the bursa and any bone spurs on the acromion. Surgeons usually do this with arthroscopy. A thin camera and small tools go in through small cuts. After surgery, complete pain relief typically takes 2 to 4 months, but it may take up to 1 year.
When to see a doctor
If certain activities bother your shoulder, stop doing them and check with your doctor. Early treatment can prevent mild rotator cuff injuries from becoming more serious later on. If your arm feels weak right after a sudden injury to your shoulder, see your doctor as soon as possible.
How a direct primary care or concierge doctor fits in
A direct primary care doctor charges a flat monthly fee instead of billing insurance, while a concierge doctor usually charges more and often works alongside insurance. Either can examine your shoulder, talk through first steps such as rest and physical therapy, and refer you to an orthopedic doctor or physical therapist when needed.
Common questions
What causes shoulder impingement?
It happens when the acromion, the top of the shoulder blade, rubs against the rotator cuff tendon and the bursa below it. Using your arm overhead again and again, as in swimming, baseball, tennis, or painting, raises the risk.
Does shoulder impingement need surgery?
Usually not at first, because in most cases the first treatment does not involve surgery. Your doctor may recommend surgery if treatment without surgery does not relieve pain.
How long does shoulder impingement take to heal?
Complete recovery may take several weeks to months with treatment that does not involve surgery. After surgery, complete pain relief typically takes 2 to 4 months, but it may take up to 1 year.
Can a steroid shot help shoulder impingement?
It may help if rest, medicines, and physical therapy do not relieve your pain.
Sources
- American Academy of Orthopaedic Surgeons - OrthoInfo - Shoulder Impingement/Rotator Cuff Tendinitis
- MedlinePlus - Rotator Cuff Injuries
Medical Disclaimer
This content is for general educational and informational purposes only and is not medical advice. It is not a substitute for professional medical advice, diagnosis, or treatment, and reading it does not create a doctor-patient relationship. Always seek the advice of your physician or another qualified health provider with any questions about a medical condition, and never disregard or delay seeking professional advice because of something you read here. If you think you may have a medical emergency, call 911 (or your local emergency number) immediately.
