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Saturday, December 12, 2020

Painful shoulder syndrome | Periarthritis humeroscapularis | PHS

Painful shoulder syndrome is also calld periarthritis humeroscapularis or PHS syndrom. The shoulder is our most mobile joint, and we can experience pain and reduced functions because of different inflammatory and degenerative changes in soft tissues of the shoulder. 

Then we speak of painful shouldersyndrome, usually presented after 40 years of age, equally in men and women. 

Sometimes painful syndrome presents itself with no apparent cause. It often causes deposition of calcium salts in shoulder tendons (m.supraspinati) where there are already signs of degeneration.

Maximum pain happens with extending the upper arm from the body for 70 to 120° – when coracoacromial ligament is touched, the pain spreads to the muscle supraspinatus towards the tuberculum humerus and joint capsule that the muscle is attached to.

Calcium salts deposited in the supraspinatus tendon can get to sub deltoid bursa and cause sudden acute inflammation, usually during the night, with strong pain and reduced shoulder mobility.  

Patient keeps the arm close to the body because even the smallest movement causes pain. 

It is necessary to do diagnostics to see what is really wrong (RTG, ultrasound). In the acute phase kryotherapy is applied. The patient needs to place the arm away from the body, e.g. by placing a pillow between the chest and the upper arm.

At the same time certain anti-inflammatory and analgesic drugs can be administered. 

After a week of therapy pain  is usually reduced and physical therapy must start as soon as possible. 

Advisable are ultrasound, laserinterferential therapy, and individual exercises to enhance the scope of mobility, along with stretching and building strength of the muscle. 

Most cases show complete recovery after 10 to 15 days of such therapy. It is very important that patient learn to perform said exercises at home.

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