Diffusive pains in the area of the shoulder girdle are such pains for which we do not find a positive explanation of their cause by examining methods as MRI, arthroscopy, X-ray or ultrasound. (But the ultrasound examination is not considered to be a sufficient tentative examination which will eliminate a serious located affection of soft tissues1).
A localization of pains is diffusive, a patient cannot localize the pains into one place.
Pains annoy rather with their chronicity than
intensity (at these pains of course exceptions exist – e. g.
acute radicular syndromes of the cervical spine).
Pains are often connected to a certain movement, and they
are evoked only in a certain position. The patient mostly tries to do the
movement several times until he does the one which evokes the pain.
A restriction of the extension of the movement is minimal or
is not present.
An isometric contraction
is not very weakened, its soresness very often occurs.
A morning stiffness, a reinforcement of pains at night and during lying on the affected side (showing that there is an inflammatory affection) are not there.
attachments of muscles of the shoulder girdle to the humerus (mainly in the area of m. deltoideus)
labrum glenoidale posterior
m. trapezius, m. supraspinatus in the whole course
attachments of muscles to the scapula
a thoracal and cervical spine paravertebrally
picture of the localization of diffusive pains in the area of the shoulder girdle
1 an exception is formed by an anamnesis of
accidental etiology where with regarding to SLAP syndrome and possibility of an
affection of the joint in the place, which is not accessible for ultrasound
examination, we continue also in other examinations as MRI or arthroscopy.