Impingement Syndrome


Related Terms

  • Internal Impingement
  • Rotator Cuff Impingement Syndrome
  • Subacromial Impingement Syndrome
  • Subcoracoid Impingement

Differential Diagnoses

Specialists

  • Occupational Therapist
  • Orthopedic (Orthopaedic) Surgeon
  • Physiatrist
  • Physical Therapist
  • Rheumatologist

Comorbid Conditions

  • Musculoskeletal disorders
  • Rheumatologic disorders
  • Rotator cuff impingement
  • Tear in the contralateral shoulder

Factors Influencing Duration

Duration depends on job requirements and whether the dominant or nondominant arm is involved. Duration and disability also depend heavily on whether the contralateral shoulder has similar problems. Disability may be longer for individuals who perform repetitive actions and/or overhead work as part of their work duties. The individual's age, occupation, response to treatment, and compliance with treatment recommendations and rehabilitation programs will influence the duration of disability. Osteoarthritis in the glenohumeral joint is uncommon but, if present, will significantly delay return to heavy work or shoulder-intensive work.

Medical Codes

ICD-9-CM:
726 - Peripheral Enthesopathies and Allied Syndromes
726.2 - Other Affections of Shoulder Region, Not Elsewhere Classified; Periarthritis of Shoulder; Scapulohumeral Fibrositis
840 - Sprains and Strains of Shoulder and Upper Arm
840.9 - Sprains and Strains of Shoulder and Upper Arm, Unspecified Site of Shoulder and Upper Arm; Arm NOS; Shoulder NOS

Return to Work (Restrictions / Accommodations)

Aggravating activities need to be avoided until symptoms have been relieved. During early treatment, the individual should not lift, carry, push, or pull heavy objects. Individuals should not use the arm with the hand above shoulder level. These restrictions may become permanent. An ergonomic evaluation of the workplace may be necessary. A change in job duties, sharing or alternating tasks, a reduced work rate, more frequent rest breaks, and limits on the time and frequency of repetitive activities are important accommodations. Work-site modifications can include forearm rests for individuals who use computer keyboards frequently, headsets for those who answer telephones, and modifications to repetitive activities so that they can be done without raising the arms. Individual attention and education can encourage recognition and avoidance of aggravating activities, awareness of shoulder mechanics and early signs of impingement syndrome, and use of proper warm-up techniques.

Source: Medical Disability Advisor






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