Painful arc syndrome describes pain felt in a specific band of shoulder elevation — typically between 60° and 120°. Below and above that band the arm often moves freely, which is why the condition is so recognisable in clinic.
The mechanism is impingement: as the arm lifts, the subacromial space narrows and the rotator cuff tendons and bursa are compressed against the acromion. Repeated compression causes inflammation, which narrows the space further.
How it is assessed
Assessment combines a movement examination with ultrasound imaging, which shows the bursa and cuff tendons in real time and while the arm moves — something a static scan cannot do.
Non-surgical management
Most patients recover without surgery. Treatment centres on restoring scapular control, strengthening the rotator cuff, and where inflammation dominates, an ultrasound-guided subacromial injection to break the pain cycle so rehabilitation can proceed.
