Shoulder impingement can cause pain with lifting, reaching, overhead activity, sleeping on the shoulder, or reaching behind the back.
Shoulder impingement can make reaching, lifting, and sleeping uncomfortable. Dr. Siefferman discusses what's causing the pain and the treatment options available to restore comfortable movement.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Hi, I’m Dr. Jason Siefferman, medical director at Manhattan Pain Medicine. Shoulder impingement very specifically refers to the supraspinatus tendon, which runs under the acromion and attaches to the humeral head. If you can imagine the socket of the joint here with the acromion here, humeral head here, supraspinatus tendon coming through and landing right there.
When the shoulder comes up and internally rotates, if the humeral head is not adequately depressed for the shoulder to flex, it will glide and grind right against that acromion. And when it does, the supraspinatus tendon will be impinged. And that’s what we call shoulder impingement. To fix this, we have to understand the reason why it’s happening, which can be something like a cervical radiculopathy. It can be other rotator cuff tears or sprains. It can be disuse.
Sometimes there’s no clear reason why it happens, but treatment includes strengthening the rotator cuff muscles, identifying any other reason that might be contributing to the impingement like a hooked acromion, and then lining these things up and getting a treatment plan together.
Shoulder impingement is a shoulder pain pattern that often involves irritation or pinching of soft tissues around the rotator cuff or bursa during arm movement.
Patients may feel pain when reaching overhead, lifting, throwing, sleeping on the shoulder, or reaching behind the back. Pain may radiate from the front or side of the shoulder into the upper arm. Shoulder impingement can involve rotator cuff irritation, bursitis, shoulder blade mechanics, tendon overload, inflammation, joint instability, posture, or structural narrowing.
Because similar symptoms can come from frozen shoulder, rotator cuff tear, neck referral, arthritis, or hypermobility, diagnosis-first evaluation is important before treatment begins.
At Manhattan Pain Medicine, evaluation begins by identifying whether shoulder impingement is the primary pain generator or part of a broader shoulder, neck, scapular, or hypermobility pattern.
For patients looking for shoulder impingement treatment in Manhattan, MPM evaluates shoulder pain with lifting, overhead activity, reaching, sleep, strength, range of motion, rotator cuff symptoms, scapular dyskinesia, frozen shoulder, neck referral, EDS, and hypermobility-related instability.
Care may include diagnostic ultrasound, ultrasound-guided injections, steroid injections, PRP, BMAC, prolotherapy, rehabilitation coordination, or orthopedic referral when appropriate.
Shoulder impingement can be a useful clinical description, but it does not always explain why the shoulder hurts. In some patients, pain is driven by rotator cuff irritation or bursitis. In others, impingement symptoms may be the result of poor scapular mechanics, shoulder instability, hypermobility, frozen shoulder, cervical radiculopathy, tendon injury, arthritis, or chronic pain sensitization.
MPM uses a diagnosis-first approach to determine what is actually generating the pain. The evaluation considers where the pain occurs, which movements trigger it, whether the shoulder is weak or stiff, whether pain is coming from the neck, and whether shoulder blade mechanics or joint laxity are contributing. This helps guide treatment toward the true pain source rather than treating all overhead shoulder pain the same way.
Shoulder impingement fits within MPM’s Musculoskeletal issues Zone of Expertise, with important overlap in Hypermobility when EDS, joint laxity, shoulder instability, or altered mechanics contribute to symptoms. This matters because shoulder pain with lifting or reaching may involve the rotator cuff, bursa, shoulder blade, neck, capsule, tendons, or joint stability.
MPM uses the Zones of Expertise framework to evaluate whether symptoms appear tendon-related, bursal, capsular, nerve-related, scapular, instability-related, referred from the neck, or part of a chronic pain pattern. This helps guide whether the next step should be movement-based care, diagnostic ultrasound, ultrasound-guided injection, regenerative discussion, orthopedic referral, or broader coordinated care.
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit Manhattan Pain Medicine because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
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After two years of searching and feeling lost and let down, I finally found real help at Manhattan Pain Medicine. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I’m finally getting answers with m...
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The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Shoulder impingement is a shoulder pain pattern that often involves irritation or pinching of soft tissues, commonly the rotator cuff tendons or bursa, during arm movement. It may occur when shoulder mechanics, tendon irritation, inflammation, posture, scapular movement, bone shape, or instability reduce space or increase stress around the shoulder. Shoulder impingement can cause pain with reaching, lifting, throwing, sleeping on the shoulder, or overhead activity. It should be evaluated in context because similar symptoms can come from frozen shoulder, rotator cuff tear, neck referral, arthritis, or hypermobility.
Shoulder impingement often feels like pain in the front or side of the shoulder, sometimes radiating toward the upper arm. Pain may worsen with reaching overhead, lifting, throwing, sleeping on the affected side, reaching behind the back, or moving the arm suddenly. Some patients feel stiffness, tenderness, weakness, or a painful arc when raising the arm. Night pain is also common. These symptoms can overlap with rotator cuff disease, bursitis, frozen shoulder, cervical radiculopathy, shoulder instability, or inflammatory conditions, so careful evaluation matters.
Shoulder impingement may be caused by rotator cuff irritation, bursitis, overuse, shoulder blade mechanics, poor load control, tendon changes, inflammation, bone shape, posture, instability, or hypermobility. Repetitive overhead activity, throwing, lifting, desk posture, sports, or prior injury may contribute. In patients with EDS or hypermobility spectrum disorder, joint laxity may increase reliance on muscle control and scapular mechanics, which can affect shoulder loading. The cause matters because treatment should address the driver, not only the symptom of shoulder pain.
Shoulder impingement is evaluated through medical history, physical examination, movement testing, strength testing, range-of-motion assessment, imaging review, and diagnostic ultrasound when appropriate. The clinician may assess rotator cuff strength, pain with overhead motion, scapular movement, tenderness, neck referral, and signs of frozen shoulder or instability. Diagnostic ultrasound can help evaluate selected soft tissue structures, such as rotator cuff tendons or bursal irritation, and may guide injections. In some cases, additional imaging or orthopedic evaluation may be needed.
Shoulder impingement usually causes pain with certain movements, especially lifting or reaching overhead. Frozen shoulder, also called adhesive capsulitis, typically causes significant stiffness and loss of both active and passive shoulder motion. A patient with impingement may have pain when raising the arm, while a patient with frozen shoulder may feel blocked in multiple directions, even when someone else tries to move the shoulder. These conditions can overlap or be confused with each other, so range-of-motion testing and diagnosis-first evaluation are important.
Yes. Cervical radiculopathy or referred neck pain can mimic shoulder impingement. Neck-related pain may cause shoulder pain, arm pain, numbness, tingling, weakness, or symptoms that change with neck position. Some patients have both shoulder and neck contributors. MPM evaluates neck motion, nerve symptoms, shoulder strength, range of motion, and pain location to help determine whether symptoms are coming from the shoulder, the cervical spine, or both. This distinction matters because neck-related shoulder pain requires a different treatment pathway than rotator cuff or bursal irritation.
Treatment depends on the pain source. Options may include activity modification, physical therapy coordination, shoulder and scapular mechanics, rotator cuff strengthening, medication management when appropriate, and ultrasound-guided steroid injections in selected cases. If another pain generator is identified, such as frozen shoulder, neck referral, shoulder instability, or tendinopathy, treatment may need to change. PRP, BMAC, prolotherapy, or regenerative medicine may be discussed only for carefully selected patients after the diagnosis, anatomy, risks, goals, and evidence are reviewed.
PRP, BMAC, and prolotherapy may be considered only in selected shoulder pain cases after careful evaluation. These treatments are not automatic for shoulder impingement and should not be described as guaranteed tendon repair, bursa repair, structural correction, or a replacement for surgery when surgery is medically indicated. They may be discussed when the pain pattern involves selected tendon, ligament, instability, or chronic musculoskeletal contributors. MPM evaluates the diagnosis, anatomy, imaging findings, severity, risks, and patient goals before considering regenerative options.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Shoulder impingement is a common shoulder pain pattern that often involves irritation of the rotator cuff tendons, bursa, or surrounding soft tissues during arm movement. Patients may feel pain when lifting the arm, reaching overhead, throwing, sleeping on the shoulder, reaching behind the back, or using the arm repetitively. Pain may occur in the front or side of the shoulder and may travel toward the upper arm.
Shoulder impingement can be frustrating because it often affects daily activities: dressing, washing hair, lifting groceries, exercising, working at a desk, reaching into cabinets, or sleeping. Some patients feel a sharp catch. Others feel a deep ache, weakness, stiffness, or tenderness.
The shoulder is highly mobile and depends on coordinated movement between the shoulder joint, rotator cuff, shoulder blade, collarbone, neck, ribs, and upper back. Impingement symptoms may occur when shoulder mechanics place extra stress on the rotator cuff or bursa. This can happen with overuse, tendon irritation, bursitis, poor scapular movement, posture, bone shape, inflammation, or weakness.
In some patients, shoulder instability or hypermobility is part of the pattern. People with EDS or hypermobility spectrum disorder may rely heavily on muscle control to stabilize the shoulder. If the shoulder blade, rotator cuff, or surrounding muscles cannot manage that load, pain may develop with lifting or overhead activity.
Not all overhead shoulder pain is shoulder impingement. Rotator cuff tear, frozen shoulder, arthritis, cervical radiculopathy, bursitis, tendinopathy, shoulder instability, inflammatory disease, and referred pain can create similar symptoms.
Frozen shoulder usually causes more global stiffness and loss of both active and passive motion. A rotator cuff tear may cause weakness or pain with resisted movement. Neck-related pain may involve numbness, tingling, radiating arm pain, or symptoms that change with neck position. Scapular dyskinesia may alter shoulder blade motion and contribute to impingement-like symptoms. Diagnosis-first evaluation helps separate these possibilities.
MPM begins with a detailed history and examination. The clinician reviews where pain occurs, what movements trigger it, whether pain affects sleep, whether there is weakness or stiffness, and whether symptoms began after injury, repetitive activity, or gradual overuse. Prior imaging, physical therapy, injections, medication response, and orthopedic evaluations are also reviewed.
The physical exam may assess shoulder range of motion, rotator cuff strength, tenderness, scapular mechanics, impingement signs, neck mobility, nerve symptoms, and signs of instability or frozen shoulder. Diagnostic ultrasound may be used when it can help evaluate rotator cuff tendons, bursal irritation, or guide injections. Additional imaging may be reviewed or coordinated when structural injury is suspected.
Treatment depends on the pain generator. Many patients begin with activity modification, physical therapy coordination, rotator cuff strengthening, scapular stabilization, range-of-motion work, and gradual return to activity. Medication management may be considered when appropriate.
If pain remains significant or limits participation in therapy, an ultrasound-guided steroid injection may be considered in selected cases. Steroid injections may help reduce inflammation and pain, but they are not a stand-alone solution. They are often most useful when paired with movement-based care that addresses strength, control, and mechanics.
Image-guided injections can improve precision when a specific target is identified. In some cases, injections may also help clarify whether symptoms are coming from a bursa, tendon region, joint, or another pain generator.
Some patients ask about PRP, BMAC, prolotherapy, or regenerative medicine for shoulder impingement. These options may be discussed only when the diagnosis, anatomy, imaging findings, risks, goals, and evidence support them. They should not be presented as guaranteed tendon repair, structural correction, or a replacement for surgery when surgery is medically indicated.
Orthopedic referral may be appropriate when there is suspected rotator cuff tear, severe weakness, structural narrowing, recurrent instability, persistent loss of function, significant trauma, or symptoms that do not improve with appropriate nonsurgical care. Surgery may be considered in selected cases, but many patients begin with conservative and image-guided options before surgical evaluation is needed.
Shoulder pain should be evaluated when symptoms persist, worsen, limit range of motion, cause weakness, interfere with sleep, follow trauma, or are associated with numbness, tingling, fever, redness, severe swelling, chest pain, shortness of breath, sudden weakness, or rapidly worsening function. These symptoms should not be assumed to be simple shoulder impingement.
MPM approaches shoulder impingement through a diagnosis-first, function-focused model. The evaluation considers rotator cuff irritation, bursitis, scapular dyskinesia, frozen shoulder, neck referral, EDS, hypermobility-related instability, tendon injury, arthritis, inflammatory disease, and chronic pain sensitization.
For patients looking for shoulder impingement treatment in Manhattan, MPM offers a careful pain medicine perspective that can work alongside physical therapy, orthopedics, sports medicine, and rehabilitation. The goal is to identify the true source of shoulder pain, reduce unnecessary escalation, and build a treatment plan that supports motion, strength, sleep, and function.
