The painful arc observed in shoulder elevation typically occurs between which range of degrees?

• A. 60 to 90 degrees
• B. 90 to 120 degrees
• C. 120 to 160 degrees
• D. 160 to 180 degrees

Answer: (C)

The painful arc phenomenon in shoulder elevation is commonly associated with the range of motion that reflects impingement of the rotator cuff structures as they pass under the acromion. Typically, this painful arc occurs between 60 to 120 degrees of shoulder abduction or flexion.

In this range, as the arm is raised, the greater tuberosity of the humerus can impinge upon the acromion, leading to pain, particularly if there are underlying pathologies such as rotator cuff tendinopathy or bursitis. The initial phase (60 to 90 degrees) is where patients often report discomfort due to the mechanical compression of the shoulder structures. Although the answer provided was C (120 to 160 degrees), it is vital to clarify that while some pain can occur past 120 degrees, the typical and more significant painful arc is recognized primarily in the lower range of 60 to 120 degrees. Thus, acknowledging 60 to 90 degrees captures the classic understanding of the painful arc.

This understanding aids clinicians in assessing and diagnosing shoulder conditions, as identification of this specific range can help in guiding treatment and rehabilitation efforts for related pathologies.