08/07/2025
♨️ 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.
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🎯 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°)
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📌 Clinical Features:
Pain during active shoulder abduction, especially between 60°–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
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🧪 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)
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💪 Physiotherapy Treatment:
✅ Acute Phase:
Rest and avoid painful arc movements
Ice therapy 🧊
Anti-inflammatory medications (if prescribed)
✅ Subacute 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)
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✳️ Electrotherapy:
TENS for pain
Ultrasound to reduce inflammation
IFT to stimulate blood flow
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🎯 Exercise Examples:
Pendulum exercises
Wall crawls
Isometric rotator cuff strengthening
Scapular setting exercises
✅ Physio Masud
❗ Important Note:
If untreated, painful arc syndrome can progress to chronic rotator cuff tear or frozen shoulder.
