Rheumatoid Arthritis Complications: Impingement Syndrome
How Impingement Syndrome Develops
As the arm raises or lowers, the tendons attached to the rotator cuff rub against a bone in the shoulder called the acromion. As this friction continues, the muscles begin to swell, decreasing blood flow to the area. When this happens, the muscles start to fray, and could possibly tear in two.
This condition is common in people who engage in activities where they are required to continually raise their arms over their heads. Swimming, tennis, pitching in baseball, construction workers, and paper hangers are all at an increased risk of developing impingement syndrome. RA patients may suffer from impingement syndrome due to the joints in their shoulders being inflamed as a result of their condition.
Initial signs of impingement syndrome may include minor aching in the shoulder area. Usually, this first sign seems trivial and is ignored. The aches may be attributed to a recent activity or "sleeping in a bad position" during the night. As the condition progresses the following additional symptoms will be noticed:
- Persistent pain that spreads out from the shoulder into the arm.
- Pain continues even when resting the shoulder.
- Sharp pain may be present when the arm is raised or lowered.
- Difficulty sleeping due to shoulder discomfort.
- Reaching, especially behind the back, may be laborious and painful.
- When the arms are lowered, a "catch" may be felt.
As the joints become more aggravated, they will stiffen up. Strength will be lost and range of motion may decrease completely resulting in a "frozen shoulder." If a patient cannot move their shoulder, or lift and lower their arm, the rotator cuff may have been torn. It's possible to experience a rotator cuff tear and be oblivious, as it's been estimated that as many of 40% of individuals may have one and not know it.
Oral medications used for reducing inflammation are most often prescribed for impingement syndrome. Each person will respond differently to each NSAID, and your physician may need to try several medications to find the one that will work for you.