Painful Arc Syndrome
Do you face difficulty in lifting your hand sideways? Do you feel a sharp pain on the tip of the shoulder when you try to reach for something overhead? If you do, it can be case of painful arc syndrome.
What is painful arc syndrome? It can commonly be called a shoulder pain. But what causes this pain? What happens to the bones and muscles that work our body to cause such an ache? To understand that, let us look into the anatomy of the shoulder and try to figure out what causes the painful arc syndrome.
The shoulder joint earns its stability from the rotator cuff muscles. These are a group of 4 muscles that help in the movement of the shoulder joint. To be more precise, the tendons of these muscles help in stabilizing the head of the humeral bone (the bone in the upper arm) in the joint capsule.
The tendon from one of these muscles, the supraspinatus, impinges on the bone that forms the tip of the shoulder, also known as the acromion. The subacromial bursa, the fluid-filled sac makes sure there is no friction between the tendon and acromion.
Sometimes, due to constant usage, wear and tear occurs in the tendons that results in supraspinatus tendonitis. This may happen due the inflammation of the bursa. This condition is known as subacromial bursitis.
There may also be a tear in the tendons which may be partial or it may be total. Tendonitis and tears cause the painful arc. This is felt most when a person tries to lift his or her arm sideways and upwards. The pain recedes when the arm is vertical to the body.
Besides wear and tear of the tendons and inflammation of the bursa, there are other conditions that can lead to a painful arc syndrome.
Arthritis of the acromio-clavicular joint or the tip of the shoulder may be one of the important factors causing the condition of a painful arc syndrome.
In this case, however, the pain is felt only when the arm is almost vertical to the body.
The painful arc syndrome is common occurrence among athletes and sportsmen and women. This is because they use this joint to its maximum capacity. However, it may also happen due to trauma. The painful arc syndrome may result due to a fall. Bilateral condition or painful arc syndrome in both shoulders is not very common. It has been seen in 5% of such cases. This painful condition typically restricts shoulder movement and causes secondary muscular pains.
The painful arc syndrome improves mostly within 20 days, on its own. Physiotherapy and steroidal injections help in providing relief sooner. But there is always a chance of relapse in the future. Complete tear of the tendon may be surgically improved in young people. But it is not a solution for older patients, especially those with rheumatoid arthritis. Persistent trauma and constant impingement may lead to osteoarthritis in the future.
Analgesics with food everyday, injection of corticosteroids and local anesthesia into the subacromial bursa help in treatment of the painful arc syndrome. Calcific tendonitis may need steroids or surgical removal of calcium crystals to provide relief.