 Hi, I am Dr. Sushal Shantakumar. I am a consultant shoulder surgeon practicing in Manipal Hospital, Bangalore. You can pick up impingement syndrome at an early stage. It is very much treatable with conservative methods. The initial treatment will be rest. You can give rest to the involved shoulder for a period of few days where the acute pain settles. Ice therapy or cold therapy will help initially to bring down the acute pain. When the acute pain settles, we put them on a regimen of physiotherapy to strengthen the involved muscles, especially the supraspinatus muscles. This involves strengthening the muscles involving therabans or resistance bands. You can also put them on non-steroidal anti-inflammatory medications. In unresponsive patients, intraarticular steroid injections can also be given. Small subgroup of patients who do not respond to any methods, you might have to consider arthroscopic surgery. What do we do in arthroscopic surgery? We shave the under surface of the bone which presses on the involved tendons and will have to dibrite the involved tendons. So, following which you will be put on physiotherapy and you can recover your regain motion.