PAINFUL ARC SYNDROME

Other Names

• Impingement syndrome
• Supraspinatus syndrome
• Swimmer’s syndrome
• Thrower’s shoulder

Clinical syndrome characterized by pain in the shoulder during an arc of movement between 60° and 120° of abduction. 

Etiology

1. Minor tears of the supraspinatus tendon
2. Supraspinatus tendinitis
3. Calcification of supraspinatus tendon
4. Subacromial bursitis
5. Fracture of the greater tuberosity
6. Increase in bulk of the contents in the subacromial space, seen in inflammation of the rotator cuff 

Clinical Features

• Pain, weakness and a loss of movement at the affected shoulder.
• Pain worsened by overhead movement.
• Pain worsened by lying on the affected shoulder.
• Grinding or popping sensation during movement 

X-ray of the shoulder may show :

• calcific deposit, or
• a fracture of the greater tuberosityor acromion 

• Treatment depends on the pathology that is causing impingement.

1. Nonoperative

• Anti-inflammatory drugs

2. Operative

• Procedures aim at enlarging the subacromial space and decompressing it.
• Shaving of the spur (when present)
• excision of the impinging acromion

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