Bursitis of the shoulder

Subacromial bursitis is a common cause of shoulder pain which happens when the bursa in the shoulder becomes inflamed.

Definition

Bursae are small fluid filled sacs found throughout our bodies which sit between the muscles, tendons and bones in areas where two surfaces move against one another. Their purpose is to reduce the friction between the moving areas.

The subacromial bursa, which sits at the top of the shoulder, is one of the largest in the body and the one most commonly injured. When the bursa becomes inflamed or irritated it results in a condition called bursitis.

Causes

Bursitis is a condition which commonly has a gradual onset and is generally caused by an overloading of the complex structures in the shoulder. It can occur at any age but becomes more likely with aging.

Repetitive overhead activities/movements cause micro trauma to the bursa which then worsens over time, resulting in bursitis. Those who need to raise their arms repeatedly over their heads for work or sport are at a much higher risk of developing shoulder bursitis.

Traumatic bursitis results from a specific traumatic incident such as a fall. The direct impact can result in inflammation of the bursa.

Bursitis can also be caused by infection. This is known as septic or infective bursitis.

Due to the complexity of the bony and soft tissue structures of the shoulder joint, any condition affecting the joints, the associated rotator cuff tendon or shoulder stabilising muscles can also cause irritation and inflammation of the bursa. Systemic inflammatory conditions such as rheumatoid arthritis, which causes inflammation in the joint, can also cause inflammation in the bursa. Osteoarthritis of the shoulder can cause bony spurs called osteophytes. These are commonly found under the acromion – the bony tip at the end of the shoulder – and can directly irritate the subacromial bursa.

Signs & Symptoms

The main symptom of shoulder bursitis is pain. This can be aggravated by overhead and repetitive activities. The shoulder becomes painful to touch and people report difficulty in sleeping as they are unable to lie on the affected shoulder.

As the pain intensifies, it is common for sufferers to stop using or moving the shoulder which in turn reduces range of motion and increases weakness.

If a septic or infected bursitis is present, fever, fatigue, redness and warmth is also present.

How Can I Prevent Shoulder Bursitis?

• Temporarily stop any aggravating activities if mild symptoms develops
• Maintain good posture during daily activities
• Maintain good strength and mobility around your shoulder joint/muscles

Treatment

Early physiotherapy assessment and treatment is recommended for shoulder pain. Early intervention is best to avoid developing compensatory strategies which can progressively worsen the symptoms.

Physiotherapy treatment typically involves:

• Education
• Activity modification advice
• Postural advice
• Shoulder exercises to increase the stability, strength and function in the shoulder

Interventions such as anti-inflammatory medications, pain medications/gels and ice are also beneficial.

Infected bursitis needs prompt medical management with antibiotics.

In some circumstances, further intervention such as corticosteroid injection or surgery is required.

Melbourne Hand Therapy Can Help You

At Melbourne Hand Therapy, our Upper Limb Physiotherapists are experienced to treat all shoulder conditions.

Your therapist will conduct a thorough subjective and objective examination to determine the cause of your pain. They will work with you to construct an appropriate and personalised management plan to allow you to achieve set goals and return to your normal, pain-free activities.

If you have shoulder pain then click on the link below to book with one of our physiotherapists today.

If you are experiencing any of these symptoms, book an appointment.