Painful Arc Syndrome: A Comprehensive Guide to Diagnosis and Management

PAINFUL ARC SYNDROME

Painful Arc Syndrome refers to shoulder pain that occurs within a specific arc of arm elevation, typically between 60° and 120° of abduction. Outside this range, movement is usually less painful or pain-free.

Common Causes:

1. Supraspinatus tendinopathy or partial tear

2. Subacromial bursitis

3. Shoulder impingement syndrome

4. Calcific tendinitis

5. Acromioclavicular (AC) joint pathology (pain > 160°)

Clinical Features:

• Pain during active shoulder abduction, especially between 60° and 120°
• No pain during passive abduction
• Pain subsides after 120°
• Often worse with overhead activities
• May have night pain or difficulty sleeping on affected shoulder

Diagnosis:

• Observation during shoulder abduction
• Hawkins-Kennedy test, Neer’s impingement test
• MRI or ultrasound may reveal rotator cuff or bursa involvement

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⁣Differential Diagnosis:

• Rotator cuff tear
• Frozen shoulder (adhesive capsulitis)
• Labral tear
• AC joint arthritis (if pain at >160° abduction)

Physiotherapy Treatment:

Acute Phase:

• Rest and avoid painful arc movements
• Ice therapy⁣
• Anti-inflammatory medications (if prescribed)

Sub-acute to Chronic Phase:

• Postural correction
• Strengthening exercises for rotator cuff and scapular stabilizers
• Stretching of tight shoulder muscles
• Manual therapy techniques to reduce subacromial pressure
• Therapeutic modalities (ultrasound, TENS, laser)

Electrotherapy:

• TENS for pain
• Ultrasound to reduce inflammation
• IFT to stimulate blood flow

Exercise Examples:

• Pendulum exercises
• Wall crawls
• Isometric rotator cuff strengthening
• Scapular setting exercises

Physio at Lahore Spine Care

Important Note:

If untreated, painful arc syndrome can progress to chronic rotator cuff tear or frozen shoulder.

Lahore Spine Care (Neuro and spine care) provides a painless, non-invasive, and skilled Physiotherapy and chiropractic therapy to restore spinal and joint …

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