Shoulder bursitis is the result of inflammation in the bursa. Bursae are water-filled sacs that are part of the skeletal system. They place space between the bones and connective tissues, allowing tendons, muscles and bone to move together. On the shoulder, the subacromial bursae enclose the area between the tendons of the rotator cuff and acrobatics.
Bursae allow tendons and bones to slip without friction as you move and raise your arms. Injuries or overuse can cause fluid to accumulate in the bursae, resulting in bursitis. Painful swelling can occur slowly or suddenly. Healthcare providers may use the medical term subacromial bursitis or rotator cuff tendinitis to refer to bursitis affecting the shoulder.
What to know about subacromial bursitis treatment
Shoulder bursitis usually occurs in people over 30 and is a serious condition in women. Younger and middle-aged patients are more likely to get severe bursitis than older patients with chronic rotator cuff disease. No significant differences in incidence were found between men and women specific to subacromial bursitis. Subacromial bursitis usually produces back or external shoulder pain.
Patients regularly report one major traumatic event that causes ongoing pain. Lifting up or reaching activity is stressful, and the pain is often worse at night. The symptomatic system of Subacromial bursitis may occur in connection with tears of the rotator cuff, interstitial disease, fractured shoulder, or systemic inflammatory disease such as polymyalgia rheumatica or septic arthritis.
Scapulothoracic Bursitis is caused by mechanical pressure and friction between the upper extremity of the scapula and adjacent ribs. The pain and feeling of “popping” is a common complaint. Additional activities include repetitive movements such as working up, reaching up and forward, or doing pushups. Internal tenderness and receptive crepitus are characteristic. Complications or bleeding within the area may be seen on MRI.
Different types of shoulder bursitis include;
Infectious; In rare cases, bacterial infections like staph infections cause shoulder bursitis. The shoulder may appear red or purple and feel warm to the touch. In this rare case, you may have a fever and feel sick. You may have severe shoulder pain.
- Chronic; Repeated injuries or recurrent episodes of severe bursitis can lead to chronic shoulder bursitis. It is the most common type of shoulder bursitis. You may have periods without symptoms and then develop symptoms that last for several months.
- Acute; This type comes on suddenly, often from an accident or injury. Touching or moving the shoulder causes pain.
Symptoms of subacromial bursitis
If you have subacromial bursitis, you may experience shoulder stiffness and pain. It can be very painful to wake up at night. There may also be swelling and redness. Your shoulder can be rough to the touch, especially the front or upper third of your arm. Shoulder pain from bursitis can come on suddenly or slowly. You may experience mild pain, severe pain or tenderness.
Other symptoms of subacromial bursitis include;
- Shoulder stiffness or a feeling of swelling.
- In the face of pain.
- Night pain when lying on the affected side.
- Severe or constructive pain with high shoulder movement.
Also in infected bursitis patients usually get excessive heat at the site of the inflamed bursa. They often complain of tenderness, pain, and fever. Swelling and redness can spread away from the affected web and go up or down the arm.
Factors contribute subacromial bursitis
Sometimes, the wound destroys the bursa on your shoulder. Misuse of your shoulder muscles can also cause damage. People who do a lot of work to lift up and pull hard on your work are in danger. Being industrious can also be detrimental to your bursa, especially if the game you are playing involves throwing or hitting. Other factors that can help cause this type of bursitis:
- Your age; Bursitis in your shoulder becomes more likely to get older.
- Poor posture; Stay tuned, don’t miss out.
- Poor flexibility; Stretch before exercising.
The shape of your shoulder blade can be a factor as well. You may have less space between your tendon and bursa than most people. Infections, arthritis, gout, diabetes, or thyroid disease may also play a role.
Causes of subacromial bursitis
The most common causes of bursitis are injury or misuse. Infections can also cause it. There are several ways to get bursitis, but the condition is usually caused by a lot of stress on the bursa. In general, however, bursal irritation can be divided into three groups.
Chronic bursts; it may be due to a variety of reasons. This type is common and grows over time because of the recurrence of the bursa. Most people who get this type do not have trouble predicting, and inflammation occurs for no apparent reason. Occasionally it can occur in people who have an existing medical condition that causes bursa inflammation.
Infected bursitis; it’s worse. In this type, the bursa is infected with bacteria. If the infection spreads, it can cause serious problems.
Traumatic bursitis; Of the three species, they are the most common. It is because of the repeated rubbing on the hard surface or from the very bending of the joint.
Diagnosis of subacromial bursitis
Your doctor will ask about your symptoms. They will check to see if your shoulder is warm to the touch or tender. They will also move your arm gently in different directions to check your movements. Cognitive tests may include;
- MRI scan; An MRI scan can show any inflammation in the bursa or any damage to the bone and surrounding tissues. MRI scans are often not required for diagnosis.
- Fluid testing; Water can be taken from the bursa and tested to remove infection. This process is called longing.
- Physical exams; The physician can often diagnose bursitis by measuring the location of pain, muscle strength, and range of motion in the shoulder joint.
- Radiography; X-ray does not show the bursa itself, but can be used to control bone damage or arthritis as possible causes of shoulder pain. This can be very important in choosing the right type of treatment.
If your doctor suspects that the infection is causing your bursitis, they may order a blood test. In other cases, fluid from the bursa can be removed and tested.
Prevention of subacromial bursitis
The key to preventing bursitis of the shoulder is to reduce stress on the shoulder joint. The following prevention strategies may help:
- warm up and stretch the shoulder before exercising or using the shoulder joint regularly
- strengthen the shoulder muscles using soft exercises
- build up slowly when starting any new activity that puts stress on the shoulder
- take regular breaks when using the shoulder regularly
- improve posture to keep the shoulder muscles alive and reduce joint pressure
Treatment of subacromial bursitis
Reducing inflammation is the first step in treating shoulder bursitis. Avoid doing things that cause pain, such as reaching or stretching beyond your comfort zone.
1. Surgery
Surgery is rarely needed to treat bursitis and is usually performed only in chronic conditions that have not improved with traditional medicine. The most common surgical treatment, if needed, is incision and drainage and is used only in the case of an infected bursa. The surgeon first removes the skin with an anesthetic and then opens the bursa and head. Finally, he removes water from the burning bursa. Sometimes it is necessary to remove the entire bursa through surgery.
In most cases, subacromial bursitis improves after a few weeks of home care. If your shoulder does not change, then surgery may be an option. Your burnt bursa can be taken out so that a new, healthy one can grow in its place. Sometimes, the bone is removed to provide more space for your rotator cuff tendon. If your doctor thinks you need surgery, talk to them about which procedure will best help your shoulder.
2. Exercise
It has included shoulder reduction exercises and isolation that the patient must remember to reproduce during all normal daily activities. In addition to personal mobilization to support the recovery of motion on all sides and to strengthen isometric and elastic bands for the muscles of the Rotator Cuff. Finally, vertical stretching, abduction and medically performed rotation by setting the patient’s specific posture that allows for shortened muscle relaxation and recovery of the final degrees of movement. Ultrasound-guided injections as well as shoulder exercises in the treatment of Subacromial Bursitis are effective in reducing short- and medium-term pain.
Try the following exercises;
- Normal wall slides
- Open Stretch Book
- Rowing
- Stretching High Traps
As soon as the pain begins to subside, the physiotherapist will begin a personalized shoulder strengthening program and stretch program. Patients with shoulder bursitis can learn ways to move the shoulder in ways that will not cause inflammation.
3. Medication
The most common treatment for bursitis is the use of syringes with or without the use of a pulse or massage guide. These injections may contain steroids or other analgesic substances. Inflammation can also be treated with anti-inflammatory drugs such as Motrin, Advil, Aleve, Celebrex, or one of many others. All of these fall into the category of non-steroidal anti-inflammatory drugs. These medications help with inflammation of the tendons and bursa, as well as help reduce discomfort.
Since the appearance of bursitis is due to other medical conditions, treating the cause of this bursitis should be the first step. But since the bursa is still painful, needles are often used to treat this pain. This injection can be on the bursa, or on the muscle itself. Recent research has shown that both methods reduce pain, but there is no significant difference between the two approaches.
4. Heat and Ice packs
When a wound or misuse causes bursitis, an ice pack can help within the first 5 days. Apply ice every 15 to 20 minutes for 4 to 6 hours to reduce pain and swelling. Ice packs are available for purchase online.
We recommend icing two or three times a day for 20 to 30 minutes each time until the swelling is gone. The swelling does not go away for several weeks. Heat should not be used as it will increase swelling. Injecting steroids into the bursa may reduce inflammation and inflammation but may be associated with side effects. It is also important to compress the bursa with an elastic bandage and use padding when returning to the activity that caused the problem previously.
5. Stretch and strengthen your shoulder
Once your pain goes away, your doctor may give you some exercises to help your shoulder get back to normal. They may also recommend physical therapy. The doctor may prescribe physical therapy to stretch or strengthen the shoulder muscles and improve posture, which can help treat current bursitis and tendonitis and prevent future complications.
Your physiotherapist will also work with you to design a specific treatment plan that will speed up your recovery, as well as exercises and treatments that you can do at home. Physical therapy will help you return to your normal lifestyle and activities. The time it takes to cure the condition varies, but results can be obtained in 2 to 8 weeks, when the right stretching and strengthening program is implemented.