The Painful Arc Test is commonly used in orthopedic examination of the shoulder to test for impingement of the supraspinatus tendon and/or the subacromial bursa underneath the acromion.
National Institute Of Arthritis And Musculoskeletal And Skin Diseases (NIAMS); SVG version by Angelito7, Public domain, via Wikimedia Commons
Involved Structures
- supraspinatus
- subacromial bursa
- acromioclavicular joint
Starting Position
This test is performed with the patient in sitting or standing. The patient’s arm is in neutral rotation.
Test Movement
In this position, the patient fully abducts their arm in the scapular plane.
Positive Test
The Painful Arc Test is considered positive for supraspinatus impingement if the patient reports pain between 60 degrees and 120 degrees of abduction. Pain should reduce after 120 degrees of abduction. If the patient instead reports pain at the end of abduction, acromioclavicular joint dysfunction is indicated.
Accuracy of Test
The Painful Arc Test for subacromial impingement is considered to be a fairly accurate test. Positive likelihood ratio = 2.25; 95% CI, 1.33-3.81.
Video Demonstration
video source: Educom Continuing Education
>> Return to the list of Orthopedic Tests of the Shoulder
Here are some other tests for rotator cuff pathology:
- Empty Can (Supraspinatus) Test
- Gerber’s Lift Off Test
- Hawkins Test / Hawkins-Kennedy Impingement Test
- Neer Impingement Test
Additional reading on shoulder orthopedic testing:
The Bare Minimum: Donatelli Shoulder Method Assessment and Treatment
The Bare Minimum: Donatelli Shoulder Method is an evidence based book that describes the assessment and treatment techniques of Dr. Robert Donatelli and Donn Dimond. It includes mobility testing, strength tests, and special tests along with mobilization techniques and exercises for treating shoulder pathophysiology.
Special Tests for Orthopedic Examination
First published more than 20 years ago, Special Tests for Orthopedic Examination, now in its Fourth Edition, continues to follow the authors’ initial goals of providing a simple, pocket-sized manual for practical learning purposes.