What is Shoulder Bursitis?
Sub-acromial bursitis is a common cause of shoulder pain that is usually related to impingement (squashing) of your bursa between your rotator cuff tendons and bone (acromion). Your sub-deltoid bursa is less commonly inflamed of the shoulder bursa, however the subacromial is normally connected to the subdeltoid and 7 other bursae !.
What are the Symptoms of Shoulder Bursitis?
- Gradual onset of symptoms over weeks or months
- Pain on the outside of the shoulder
- Pain may spread down the arm towards the elbow or wrist
- Pain made worse when lying on affected side
- Pain made worse when using the arm above head
How to Diagnose Shoulder Bursitis
The best way to diagnose it is:
- Clinical tests.
- Ultrasound scan
What Causes Shoulder Bursitis?
- Local Pathology or Disease (calcification)
- Biomechanical Faults
- Bursitis commonly co-exists with rotator cuff tears, tendonitis or joint trauma.
|The sub-acromial bursa lies between the coracoacromial ligament and the supraspinatus muscle and helps to reduce friction in this small space under the acromion.|
When you elevate your to the side the bursa locates between the bone and muscles increasing the impingement.
|When you continue elevate your arm above shoulder height, the bursa rolls clears the impingement zone and your pain eases. However, further impingement may return at the extreme of range when your arm is adjacent to your ear.|
How Can You Prevent Shoulder Bursitis?
Eliminate the cause
Treat the inflammation
Factors such as posture, muscle and joint flexibility, shoulder stability and strength need to be addressed. These can be optimised with specific exercises prescribed by your physiotherapist.
What is Calcific Shoulder Bursitis?
Calcific bursitis (bone growth within the bursa) occurs when chronic inflammation in the bursae leads to calcium being deposited by the body. If physiotherapy rehabilitation is unsuccessful, then surgical excision of the bursa may be required in these instances.
What is Chronic Shoulder Bursitis?
Chronic simply means long term. The problem with chronic conditions is that they lead to chronic inflammation which is difficult to treat and often destructive to the surrounding tissues. Sometimes a corticosteroid injection, which is an injection of cortisone to help reduce inflammation is required.
Physiotherapy prior to and after the injection have the best results.
There are a number of advantages and disadvantages with corticosteroid injection and this option should be discussed with your doctor. Diabetes and other general health issues can limit its safe use.
The best results have been shown to occur when the injection is performed under ultrasound guidance.