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M75.4 Shoulder Impingement Syndrome Explained
M75.4 is the ICD-10 code for shoulder impingement syndrome. It occurs when tendons or bursae in the shoulder are compressed, causing pain and restricted movement.
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M75.4 is the ICD-10 code for shoulder impingement syndrome. It occurs when tendons or bursae in the shoulder are compressed, causing pain and restricted movement.
What is M75.4 – Shoulder Impingement Syndrome?
The ICD-10 code M75.4 refers to shoulder impingement syndrome, also called subacromial impingement syndrome. It describes a condition in which the soft tissues of the shoulder – particularly the tendons of the rotator cuff and the subacromial bursa (a fluid-filled sac) – become compressed or pinched beneath the roof of the shoulder joint (the acromion). This leads to irritation, inflammation, and pain. It is one of the most common causes of shoulder pain in adults.
Causes
Shoulder impingement syndrome can develop due to various mechanical and biological factors:
- Anatomical factors: A hooked or curved acromion, bone spurs (osteophytes), or calcium deposits in the tendons
- Functional factors: Muscle imbalances around the shoulder, poor posture, or repetitive overhead activities (e.g., swimming, tennis, painting)
- Degenerative changes: Age-related wear and tear of the tendons and joint structures
- Traumatic causes: Previous shoulder injuries or falls
Symptoms
Common symptoms of M75.4 include:
- Pain on the outer side of the shoulder, often radiating down the upper arm
- Pain when raising the arm, especially between 60° and 120° of elevation (the so-called painful arc)
- Night pain, particularly when lying on the affected side
- Weakness and limited range of motion in the shoulder
- Discomfort during overhead tasks or activities
Diagnosis
Diagnosis is based on a clinical examination and imaging investigations:
- Clinical tests: The Neer sign, Hawkins-Kennedy test, and painful arc are standard provocation tests used in physical examination
- X-ray: Assessment of bony structures and calcifications
- Ultrasound: Visualization of tendons and the bursa
- MRI (Magnetic Resonance Imaging): Detailed evaluation of the rotator cuff and surrounding structures
Treatment
Conservative Treatment
The majority of patients with shoulder impingement syndrome are treated conservatively:
- Physiotherapy: Strengthening of the rotator cuff muscles, posture correction, and range-of-motion exercises
- Pain management: Nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation
- Corticosteroid injections: Subacromial injections for severe or persistent symptoms
- Activity modification: Avoiding painful movements and overhead activities during recovery
- Extracorporeal shockwave therapy (ESWT): Particularly useful in cases with calcium deposits
Surgical Treatment
If conservative management fails after several months, surgical intervention may be considered:
- Subacromial decompression: Arthroscopic widening of the subacromial space by removing bone or bursal tissue
- Rotator cuff repair: If a concomitant tendon tear is present
Prognosis
Most patients recover well with appropriate treatment. Early diagnosis and consistent physiotherapy are key to a successful outcome. Recurrence can be minimized through targeted muscle training and ergonomic adjustments at work and during sport.
References
- World Health Organization (WHO): ICD-10 Classification of Diseases, Version 2019 – Code M75.4 Impingement syndrome of shoulder.
- Diercks R et al. – Guideline for diagnosis and treatment of subacromial pain syndrome. Acta Orthopaedica, 2014; 85(3): 314–322.
- Koester MC, George MS, Kuhn JE – Shoulder impingement syndrome. American Journal of Medicine, 2005; 118(5): 452–455.
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