4. Pain Sites
- Pain intensity, type and location can vary with GHJ instability and depends on several
factors. The “acuteness” of macro-traumatic instability, with the possibility of bony damage
(i.e.: a bony Bankart lesion) often causes high levels of pain for the patient when the joint is
dislocated. In more chronic GHJ instability cases (such as micro-traumatic and atraumatic
instability) pain is often associated with secondary cuff overload symptoms and may be described
as “aching” or “burning” pain. - In some instances, the pain location can be vague, with the patient reporting symptoms
deep inside the joint which is hard to localise but associated with specific positions that create
excessive or uncontrolled translations of the HH. These aggravating positions may or may
not be associated with a clicking or clunking of the GHJ. - Once any secondary irritation of the rotator cuff or the GH joint surface has occurred then
more localised symptoms develop - Often with micro-traumatic and atraumatic instability there are multiple pain sites as chronic
uncontrolled translation of the HH affects tissues structures on both sides of the GHJ (ref).