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#Painful arc full
On examination there may be muscle wasting with pain on movements and a partial restriction of active movements (passive movements are full but painful).However, it often occurs in the non-dominant arm and in non-manual workers. There may be a history of heavy lifting or repetitive movements, especially above shoulder level.Subacromial impingement is the most common source of shoulder pain:.
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Most often present in patients aged 35-75 years.The term subacromial pain (synonyms: subacromial impingement impingement syndrome rotator cuff syndrome supraspinatus tendonitis rotator cuff tendinopathy painful arc syndrome) refers to all rotator cuff lesions, including all stages of tendon disease from early degeneration through to complete tears. The four most common causes of shoulder pain and disability in primary care are rotator cuff disorders, glenohumeral disorders, acromioclavicular joint disease and referred neck pain. Malignancy: apical lung cancers, metastases.Referred pain: neck pain, myocardial ischaemia, referred diaphragmatic pain (eg, gallbladder disease, subphrenic abscess).Shoulder instability - associated with hypermobility, including subluxation or dislocation (see also the separate article Shoulder Dislocation).Glenohumeral disorders: adhesive capsulitis ('frozen shoulder'), arthritis.It is also sometimes referred to as subacromial bursitis, tendonitis or tendinopathy. 'Subacromial pain', which may be due to impingement if the humeral head is not depressed sufficiently to slide under the acromion on elevation of the arm.Patients presenting in primary care often have a combination of different shoulder problems. Occupations particularly prone to shoulder pain syndromes include: cashiers, garment makers, bricklayers/construction workers, pneumatic tool operators, welders, meat/food-processing workers, hairdressers, plasterers, painters and decorators, assembly/production line workers, and workers using keyboards for long periods - eg, IT, secretarial.Athletes whose sports involve overhead activities, or high-impact contact sports, are prone to shoulder pain.Psychosocial factors related to work may also be risk factors for shoulder pain, including stress, job pressure, social support and job satisfaction.Physical factors related to occupation including repetitive movements and exposure to vibration from machine tools.Self-reported prevalence of shoulder pain is between 16% and 26%.1% of adults with new shoulder pain consult their GP each year.Shoulder pain is the third most common cause of musculoskeletal consultation in primary care.The subacromial bursa, which has a large number of pain sensors, fills the space between the acromion and the rotator cuff tendon. This passes through the subacromial space. The tendons join together to form one tendon, the rotator cuff tendon. These muscles help with internal and external rotation of the shoulder and importantly depress the humeral head against the glenoid as the arm is elevated. The rotator cuff is composed of the four muscles: supraspinatus, infraspinatus, teres minor and subscapularis that interlock to function as one unit. Ligaments and surrounding musculature, including the rotator cuff muscles, contribute to shoulder joint stability. The glenohumeral joint is the most commonly dislocated major joint in the body.
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There are three significant articulations: the sternoclavicular joint, the acromioclavicular joint and the glenohumeral joint. The humerus, glenoid, scapula, acromion, clavicle and surrounding soft tissues make up the shoulder.