Treatment of Shoulder Impingement Using LLLT/PBMT
Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), uses red and near-infrared light applied over targeted areas. In our clinic it is used as part of a GP-led treatment approach for selected musculoskeletal pain and injury presentations, including shoulder impingement.
PBMT/LLLT is non-invasive and generally well tolerated. Suitability and response vary, and treatment recommendations depend on the diagnosis, severity, duration of symptoms and individual clinical factors. PBMT/LLLT has been studied for a range of musculoskeletal pain and injury conditions. See our references page for supporting literature.
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Key Points
- Shoulder impingement occurs when the tendons or bursa in the shoulder become compressed during arm movements, particularly overhead, leading to pain and inflammation.
- It commonly affects the supraspinatus tendon and subacromial bursa, where they get “pinched” between the humeral head and acromion during movement.
- Causes include repetitive overhead activity, poor posture, rotator cuff weakness, and age-related changes or bony spurs narrowing the subacromial space.
- Symptoms include pain during overhead motion, night pain, stiffness, weakness, and a catching or clicking sensation in the shoulder.
- Impingement can coexist with tendonitis, bursitis, or partial rotator cuff tears, and requires thorough assessment to confirm the diagnosis.
- Low Level Laser Therapy (LLLT), or Photobiomodulation Therapy (PBMT), is considered for selected shoulder impingement presentations where inflammation, soft tissue irritation or tendon-related pain is contributing to symptoms.
- LLLT may be particularly relevant where pain limits rehabilitation or exercise, or where loading, stretching, injections or other interventions have provided only temporary or partial relief.
- Some commonly used approaches, such as medication, injections, repeated loading, stretching or manual pressure, may not be suitable for every stage of recovery. We provide advice based on the diagnosis, symptom severity and clinical assessment.
- Treatment is delivered under medical supervision by Dr Shikha Parmar as part of a structured, six-week program tailored to each patient’s condition.
- PBMT/LLLT has been studied in a range of musculoskeletal pain and injury conditions and is generally well tolerated. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery.
- LLLT can be considered for people with persistent shoulder pain or impingement who have not improved with usual conservative care, after appropriate medical assessment.
What is Shoulder Impingement?
Shoulder impingement syndrome is a common cause of shoulder pain where the rotator cuff tendons or subacromial bursa become compressed within the subacromial space – the narrow area between the humeral head (upper arm bone) and the acromion (part of the shoulder blade). This compression causes irritation, inflammation, and pain, particularly during overhead activities.
This repetitive compression leads to inflammation, pain, and dysfunction and may eventually contribute to rotator cuff tendinopathy or bursitis if not addressed.
Causes of Shoulder Impingement
Shoulder impingement is often the result of a combination of biomechanical and structural factors, including:
- Repetitive overhead movement (e.g. swimming, painting, tennis, lifting)
- Age-related changes such as tendon degeneration or osteophytes (bony spurs)
- Poor movement mechanics during lifting or overhead motion
- Previous rotator cuff (shoulder) or scapula injury or bursitis
Symptoms
Common symptoms of impingement include:
- Pain when lifting the arm, particularly overhead
- Discomfort during activities such as dressing, reaching, or sleeping on the affected side
- Pain that worsens with repetitive use or prolonged shoulder activity
- Weakness and reduced range of motion
- Night pain or discomfort lying on the affected side and that can disturb sleep
- Restricted range of motion or weakness in the shoulder
- A catching, clicking, or grinding sensation with shoulder movement
Symptoms may develop gradually and can often co-exist with rotator cuff tears or bursitis.
How is Shoulder Impingement Diagnosed?
Diagnosis begins with a comprehensive history and physical examination by Dr Shikha Parmar. This includes:
- Assessment of pain location, onset, and triggers
- Evaluation of shoulder alignment
- Range of movement limitations and painful arc
- Muscle strength testing
- Palpation for tenderness over rotator cuff tendons or bursa
If further clarification is needed:
- Ultrasound may reveal inflamed tendons or bursae
- X-ray can help detect bone spurs or acromial shape contributing to impingement
- MRI offers detailed imaging of soft tissues and may confirm partial tears or inflammation or more severe injury
Shoulder Impingement – Treatment Overview
Low Level Laser Therapy (LLLT), also known as Photobiomodulation Therapy (PBMT), is a non-invasive treatment approach used as part of a structured program for selected shoulder impingement presentations. It may help modulate pain and local inflammatory processes and support tendon and bursal tissue recovery without adding mechanical stress to sensitive shoulder structures.
Why Consider Low Level Laser Therapy (LLLT)?
Many patients present after limited relief from medications, physiotherapy, or injections. These approaches may ease symptoms temporarily, but are not suitable or effective for everyone, especially if loading or exercise aggravates sensitive shoulder tissues.
Why ice, anti-inflammatories, cortisone, and PRP may not support long-term recovery. Read more here.
How LLLT Supports Healing
LLLT uses red and near-infrared light and may support:
- Helping modulate inflammation and oxidative stress
- Supporting local circulation and oxygenation
- Supporting lymphatic drainage
- Supporting cellular energy production (ATP)
- Supporting tendon and bursal tissue recovery processes where irritation is present
- Assisting pain reduction without mechanical loading or stressing the shoulder joint
Non-Invasive and Supported by Research
PBMT/LLLT is non-invasive and generally well tolerated. It has been studied in a range of musculoskeletal pain and injury conditions. Individual responses vary, and outcomes depend on the condition being treated and the stage of recovery. Read more here.
See how LLLT may support the cellular environment involved in tissue recovery here.
Our Treatment Program
All patients are assessed by Dr Shikha Parmar (GP). Treatment is delivered within a structured six-week program, including:
- Up to 12 LLLT sessions
- Early progress review after the first 6 treatments
- Individualised advice and activity modification
- Guided rehabilitation to support longer-term function
Progress is reviewed during the program. Many patients notice appreciable improvement after the first 6 treatments. If there has not been sufficient improvement by this review point, further treatment may not be recommended.
View the full treatment protocol and expected outcomes here.
Ready to Discuss Your Shoulder Impingement Treatment Options?
If you are struggling with ongoing shoulder pain or signs of impingement, we invite you to contact our team at Laser Pain Therapy to discuss the suitability of LLLT for your presentation. Treatment suitability and outcomes vary, and assessment is required before recommendations can be made.
Contact us to arrange your consultation.
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