Houston Methodist. Leading Medicine

Shoulder FAQ

Question:

Whenever I reach my hand above my head, I hear (or feel, I can't decide which) a popping sound. Then it hurts like a son-of-a-gun until I'm almost all the way up, then it feels much better again. What could be causing this strange pattern?

Answer:

You may be having what's called the painful arc syndrome. The affected individual tries to raise his or her arm overhead. The motion is done with the hand down by the side. The arm is then raised out to the side as far as possible going up toward the ear.

For a positive painful arc sign, pain begins at about 60-degrees of motion and continues until the arm is at 120 degrees of elevation. At that point, the pain goes away and movement feels normal again.

A positive painful arc sign points to impingement (pinching) of one of the rotator cuff tendons of the shoulder. This is the usually the supraspinatus tendon. As the tendon moves under the arch of bone formed by the acromion, it gets pinched between the bone and the (deltoid) muscle underneath. The acromion comes from the shoulder blade and curves around over the top of the shoulder joint.

There are many possible causes of an impingement problem. The most common is postural. The position of the head, neck, and upper arms contribute to this pinching process. Sometimes arthritic changes such as bone spurs create this problem.

If your symptoms don't go away on their own in seven to 10 days, then consider seeing an orthopedic physician. The doctor will assess this problem and plan an appropriate treatment program. John G. Skedros, MD, and Todd C. Pitts. Injectable Corticosteroids for the Painful Shoulder: Patient Evaluation. In The Journal of Musculoskeletal Medicine. May 2008. Vol. 25. No. 5. Pp. 236-245.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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