If the pain in the area of the shoulder girdle deteriorates at night, if it is present at rest, and at the same time if it deteriorates during movements, if it occurs during lying on the affected side, if it is connected with a morning stiffness and a restriction of motility of the shoulder girdle – it almost always deals with the affection of the glenohumeral articulation (or acromioclavicular articulation) and periarticular structures of inflammatory etiology (most frequently tenovaginitis of the long head of the biceps), and it never deals with vertebrogenic problems which these symptoms are considered as4.
Examples of these affections can be arthritis of the glenohumeral and acromioclavicular articulation, tenovaginitis of the long head of the biceps, bursitis in the area of the glenohumeral articulation. Glenohumeral and acromioclavicular arthritis together with tenovaginitis of the long head of the biceps lead to more localized pain than other causes.
4as in the whole medicine exceptions make the rule