Summary about Disease
Painful Arc Syndrome, also known as subacromial impingement syndrome, rotator cuff tendinitis, or supraspinatus tendinitis, describes pain in the shoulder that occurs within a specific range of motion, typically between 60 and 120 degrees of abduction (lifting the arm away from the body). It's caused by the compression or irritation of tendons and/or the bursa in the subacromial space (the space between the acromion bone and the rotator cuff tendons).
Symptoms
Pain when lifting the arm away from the body, especially between 60 and 120 degrees.
Pain that may radiate down the arm.
Weakness in the shoulder, particularly when lifting or rotating the arm.
Night pain, especially when lying on the affected side.
Clicking or popping sensations in the shoulder.
Stiffness in the shoulder.
Causes
Overuse: Repetitive overhead activities, such as painting, throwing, or lifting.
Anatomical Factors: Bone spurs (osteophytes) on the acromion, which narrow the subacromial space.
Poor Posture: Rounded shoulders and forward head posture.
Rotator Cuff Weakness or Imbalance: Weak rotator cuff muscles can lead to improper shoulder mechanics and impingement.
Trauma: A direct blow to the shoulder or a sudden forceful movement.
Age-related changes: Degeneration of the rotator cuff tendons and bursa.
Medicine Used
Pain Relievers: Over-the-counter pain relievers like ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation. Acetaminophen (Tylenol) can help with pain but doesn't reduce inflammation.
Corticosteroid Injections: Corticosteroids injected into the subacromial space can provide temporary relief from pain and inflammation.
Muscle Relaxants: May be prescribed if muscle spasms are present.
Topical Medications: Creams or gels containing NSAIDs or other pain-relieving ingredients may be applied to the skin over the shoulder.
Is Communicable
No, Painful Arc Syndrome is not communicable. It is not caused by an infectious agent and cannot be spread from person to person.
Precautions
Avoid Overuse: Limit repetitive overhead activities that aggravate the pain.
Proper Posture: Maintain good posture to prevent further impingement.
Strengthening and Stretching: Perform exercises to strengthen the rotator cuff muscles and improve shoulder flexibility.
Proper Lifting Technique: Use proper body mechanics when lifting heavy objects.
Warm-up Before Activity: Warm up the shoulder muscles before engaging in activities that may stress the joint.
Ergonomics: Optimize your workstation and activities to reduce strain on the shoulder.
How long does an outbreak last?
The duration of Painful Arc Syndrome can vary greatly depending on the severity of the condition, the underlying cause, and the effectiveness of treatment. It can range from a few weeks to several months. With appropriate rest, physical therapy, and other treatments, many people experience significant improvement within a few weeks. However, chronic cases may persist for longer periods, and some individuals may experience recurrent episodes.
How is it diagnosed?
Physical Examination: A doctor will assess the range of motion, strength, and stability of the shoulder, looking for the characteristic "painful arc" during abduction.
Medical History: The doctor will ask about the patient's symptoms, activities, and any previous injuries.
Imaging Tests:
X-rays: Can help rule out other conditions, such as arthritis or fractures.
MRI: Can visualize the soft tissues of the shoulder, including the rotator cuff tendons, bursa, and labrum, to identify tears, inflammation, or other abnormalities.
Ultrasound: Can be used to evaluate the rotator cuff tendons and bursa.
Timeline of Symptoms
The timeline of symptoms can vary.
Early Stage: Pain is often mild and may only occur after activity.
Progressive Stage: Pain gradually worsens and may occur with everyday activities. The "painful arc" becomes more prominent. Night pain may develop.
Chronic Stage: Pain is persistent and may limit shoulder function. Weakness and stiffness become more noticeable.
Important Considerations
Early Diagnosis and Treatment: Seeking medical attention early can help prevent the condition from becoming chronic.
Importance of Physical Therapy: Physical therapy is often a crucial part of treatment, focusing on strengthening the rotator cuff muscles, improving range of motion, and correcting posture.
Adherence to Treatment Plan: Following the doctor's and physical therapist's recommendations is essential for a successful recovery.
Prevention: Taking precautions to avoid overuse, maintain good posture, and strengthen the shoulder muscles can help prevent future episodes.
Surgical Options: In some cases, surgery may be necessary if conservative treatments are not effective. Surgery may involve removing bone spurs, repairing torn tendons, or releasing tight ligaments.