Objective:

This purpose of this pilot study is to explore the potential usefulness of Synera for the treatment of pain associated with shoulder impingement syndrome.

Subjects will receive either a subacromial injection at baseline or will be issued Synera patches to use daily for 2 weeks and then PRN for an additional 2 weeks.

Inclusion Criteria:

• be at least 18 years of age.
• have pain associated with shoulder impingement syndrome in a single shoulder (minimum 2-week duration).
• have tenderness at the attachment site of the rotator cuff tendons.
• have positive Hawkin's and Neer's signs.
• report an average pain intensity score of 4 (on an 11-point scale) over the past 24 hours at the Screening/Baseline visit.

Exclusion Criteria:

• have used any topically applied pain medication on the target treatment area within 14 days preceding Study Day 1, such as non-steroidal anti-inflammatory drugs (NSAIDs), menthol, methyl salicylate, local anesthetics (including Lidoderm®), or steroids.
• have used any injected medication within 60 days preceding Study Day 1, such as local anesthetic (lidocaine) or steroids.
• have a clinically significant illness within 14 days of Screening/Day 1 that, in the opinion of the investigator, would preclude the subject from participating in the study.
• are receiving class 1 antiarrhythmic drugs (ie, tocainide, mexiletine, etc.)
• have a history of and/or past diagnosis of severe hepatic disease.
• have participated in a clinical trial of an unapproved drug within 30 days prior to screening.
• are pregnant, breastfeeding, or a female of childbearing potential and not practicing an acceptable method of birth control.
• are unable or unwilling, in the opinion of the investigators, to comply with all study procedures and cooperate fully with research staff.
• have filed a disability claim or are currently receiving disability payments for shoulder impingement syndrome.