Subacromial Bursitis; Causes, Symptoms, Treatment

The shoulder joint comprises of bones and several soft tissue structures like tendons, muscles, ligaments and bursa. Small sac like fluid-filled structures which protect the shoulder bones are called bursae. Subacromial Bursitis is characterized by the inflammation of the subacromial bursa in the shoulder joint. It supports the rotator cuff muscles and enables the sideways as well as overhead movement of the arm

Causes

  • Overuse injuries
  • Sports activities that involve lifting weights, throwing or overhead movement of the arm
  • Medical conditions such as Shoulder Impingement, Arthritis, bone spurs, Pseudogout etc.
  • Deposition of excessive calcium within the joint spaces
  • Instability of the glenohumeral joint
  • Tearing of the rotator cuff muscles
  • Tendon damage or degeneration
  • Weakness in the upper arm muscles
  • Trauma or injury
  • Septic or infection in the bursa
  • Falling on a hard surface
  • Poor posture

Symptoms

  • Pain while lifting the arm above the head or sideways
  • Swelling in the shoulder, mostly on the outer side
  • Limited range of motion
  • Discomfort and pain while sleeping
  • Tenderness in the upper part of the arm and shoulder
  • The skin may be red and warm when touched

Diagnosis

  • Thorough clinical evaluation of the joint by palpation and movement of the arm in different directions
  • The doctor may analyze the patient’s medical history and previous shoulder injuries
  • X-ray imaging may be done to assess the bone structure and detect bone spurs
  • MRI scan may help to reveal soft tissue damages
  • An anesthetic may be injected into the area near the bursa. If it relieves pain and reinstates range of motion, it indicates Subacromial Bursitis

Treatment

  • Rest the arm
  • Apply ice packs at regular intervals
  • Take anti-inflammatory medicines prescribed by the orthopedic doctor
  • Antibiotics may be given in case the bursa is infected
  • Heat therapy may be helpful to relieve stiffness
  • The arm may be immobilized with a removable sling
  • In case of severe pain, steroids may be injected into the bursa
  • Aspiration procedure may be performed to drain the infected fluid or calcium deposits from the bursae
  • Physical therapy may help to strengthen the muscles and joint
  • Surgical removal of the infected bursae may be required in some cases. This procedure is referred to as Bursectomy
  • Subacromial decompression may be performed to create more space for the soft tissues in the joint

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