Impingement Therapy

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Impingement Therapy
Impingement Therapy
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Impingement of the shoulder: diagnosis & therapy

Shoulder pain is common when there is a narrowing within the joint. In the presence of a shoulder bottleneck syndrome ("impingement syndrome"), physiotherapy is helpful in therapy, operations are only rarely required…

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  • Surgery rarely
  • Whom can I ask?
  • How are the costs going to be covered?

As part of the diagnosis, the doctor will inform himself in a detailed discussion with the patient (anamnesis) about the pain in the shoulder, how long it has been going on, where it can be felt, what type it is what movements they occur and whether previous treatments have already been carried out.

He / she will also ask what job or hobbies (sport etc.) you have, what pre-existing illnesses you have, what illnesses you have in the family and what medication you are taking. During the physical examination, the doctor will pay particular attention to the position and interaction in the shoulder. The muscular status also provides information about possible causes. Palpation of the joint and tendon attachments and certain movement tests of the shoulder provide important information.

The diagnosis is often clear from the clinical examination. In order to identify the cause more precisely, imaging methods such as X-rays and ultrasound are usually used. Magnetic resonance tomography (MR) is rarely necessary if an impingement syndrome is suspected.

Therapy options

Bottleneck syndromes in the shoulder are usually treated conservatively without the need for surgical intervention. Different methods of physiotherapy are used to relieve pain. Active therapy with a physiotherapist involves a combination of exercises that stretch but also strengthen the shoulder area - in particular the rotator cuff muscle group that stabilizes the shoulder joint. In physiotherapy, attention is also paid to any individual muscular imbalances.

If the pain is severe, pain relievers from the group of non-steroidal anti-inflammatory drugs (NSAIDs) can be used. Injections with a combination of local anesthetic (anesthetic to relieve pain) and cortisone (including anti-inflammatory) may also be used (" infiltration ") in the case of shoulder impingement syndrome.

In addition, methods of physical therapy such as cold can be used to relieve pain in acute complaints.

Surgery rarely

If all conservative methods lead to no or only unsatisfactory success, an operation on the shoulder may be necessary. Depending on the cause, parts of the roof of the shoulder or the corner joint, for example, are removed, and cracks are rarely sewn to the rotator cuff tendon. The operations are usually minimally invasive with a joint specimen (arthroscopy).

If left untreated, impingement can lead to stiffening or osteoarthritis of the shoulder. For more information, see Osteoarthritis: What is it?

Whom can I ask?

Do you have shoulder problems? To clarify pain in the shoulder, it is best to contact the following offices:

  • General Practitioner,
  • Specialist in orthopedics,
  • Specialist in physical medicine and general rehabilitation,
  • Specialist in trauma surgery,
  • possibly pediatrician (impingement is rare in children).

How are the costs going to be covered?

The costs of diagnosing and treating shoulder problems such as impingement are usually covered by the social security agencies.

Physiotherapy (physiotherapy or remedial gymnastics)

If physiotherapy is prescribed by a doctor and the physiotherapist has a contract with your health insurance provider, the costs will be settled directly with the health insurance provider. In certain cases or from a certain number of treatments, a chief physician's approval is required.

For elective therapists (they do not have a contract with a health insurance provider), the health insurance provider pays 80 percent of the respective contractual tariff if a doctor's prescription and, if necessary, a head doctor's approval are available. Certain social security agencies offer physiotherapy in their own facilities. The therapy is determined by the medical management; no prior authorization is required in this case. For more information, please contact your social security agency.

Further information on the cost coverage of physiotherapy, for example during a stay at a spa or in hospital, is available from Physiotherapist.

When hospitalization is required

If an operation on the shoulder is necessary, it will take place in the hospital as an inpatient. Here, the hospital costs are billed. The patient has to pay a daily contribution to the costs.

For more information, see What does a hospital stay cost?

When a rehabilitation stay is required

A rehabilitation stay is sometimes necessary after shoulder surgery. In order to receive medical rehabilitation benefits, those affected must submit a rehabilitation application in order to receive approval.

Further information is available under Rehabilitation and Cure.

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