Chulalongkorn Medical Journal


Impingement syndrome of the shoulder is a common cause of shoulder pain. Thereare three types of shoulder impingement, namely, subacromial, subcoracoid, and internalimpingement. They are described according to the location that impingement occurs. Eachcan present in isolation or combined with the others. Understanding in pathophysiology andpathomechanics of the impingement syndrome is essential in the treatment of the patient.Both static and dynamic factors play certain roles in the etiology of impingement. Clinicalevaluation of the syndrome requires thorough physical examination and appropriateinvestigations. Goals of treatment include pain relief and restoration of the shoulder function.Any structural problems should be addressed and corrected. Moreover, associated physiologicand biomechanical factors must be treated. Nonsurgical management should be the initialmode of treatment. Surgical treatment is indicated if conservative treatment fails to improvethe patient’s symptoms.


Faculty of Medicine, Chulalongkorn University

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