Introduction
Shoulder pain can be debilitating, affecting daily activities and diminishing the overall quality of life. Subacromial bursitis is a common shoulder condition that causes discomfort and limited range of motion. This article will delve into the details of subacromial bursitis, exploring its causes, symptoms, and available treatment options.
What Is Subacromial Bursitis?
Subacromial bursitis is a medical condition characterized by inflammation of the subacromial bursa, a small fluid-filled sac located in the shoulder joint. The subacromial bursa is positioned between the rotator cuff tendons and the acromion, which is a part of the scapula (shoulder blade). Its primary purpose is to reduce friction and provide a smooth, gliding surface for the tendons as they move during shoulder movements.
When the subacromial bursa becomes inflamed, it can lead to pain, swelling, and limited range of motion in the affected shoulder. The inflammation may occur due to various factors, including overuse or repetitive motions, shoulder impingement (narrowing of the space between the acromion and the rotator cuff tendons), trauma or injury to the shoulder, and age-related degeneration of the bursa.
What Are the Causes of Subacromial Bursa?
On occasion, the bursa in the shoulder may sustain injury. Additionally, excessive use of shoulder muscles can lead to damage. Those who frequently engage in overhead lifting and forceful pulling in their professions face a higher risk. Moreover, individuals with highly active lifestyles, particularly those involved in sports that require frequent throwing or pitching, are also susceptible to bursa harm.
Other factors that can cause this type of bursitis include age, as it becomes more likely as one gets older. Additionally, poor posture, which can be addressed by sitting up straight and avoiding slumping, can contribute to the condition. Moreover, limited flexibility can also be a factor, emphasizing the importance of stretching before workouts.
Furthermore, the shape of the shoulder bone can influence the likelihood of developing subacromial bursitis, with some individuals having less space between their tendons and bursa than others. Certain medical conditions such as infection, arthritis, gout, diabetes, or thyroid disease can also play a role in the development of this condition.
What Are the Symptoms of Subacromial Bursitis?
Subacromial bursitis is characterized by various symptoms that can cause discomfort and limited mobility in the affected shoulder. The severity of symptoms can vary from mild to more intense, depending on the underlying cause and individual factors. Below are the symptoms of subacromial bursitis in detail:
-
Shoulder Pain: The most common and prominent symptom of subacromial bursitis is pain in the shoulder region. The pain is usually localized to the top and outer part of the shoulder, near the acromion. It can be described as a dull, aching pain that may worsen with movement or specific activities, such as lifting objects overhead, reaching, or performing repetitive shoulder motions.
-
Limited Range of Motion: Subacromial bursitis can lead to reduced shoulder mobility. Individuals may experience difficulty in raising their arms fully, especially when reaching upward or out to the side. The pain and inflammation in the bursa can limit the shoulder's ability to move freely, affecting daily activities and sports performance.
-
Swelling and Tenderness: Inflammation of the subacromial bursa can cause swelling in the shoulder area. The affected region may appear slightly swollen and feel tender to the touch. Pressing on the swollen area can cause discomfort.
-
Warmth and Redness: In some cases, the skin over the inflamed bursa may feel warm to the touch, and there might be mild redness in the affected area.
-
Weakness: The pain and restricted range of motion may lead to weakness in the shoulder muscles. This weakness can affect the ability to perform everyday tasks that involve lifting or carrying objects.
-
Pain at Night: Some individuals may experience increased shoulder pain at night, especially when lying on the affected side. This can disrupt sleep and contribute to overall discomfort.
-
Grating Sensation: In certain instances, individuals with subacromial bursitis might experience a grating or popping sensation in the shoulder during movement. This sensation, known as crepitus, is caused by friction between the inflamed bursa and surrounding structures.
How to Diagnose Subacromial Bursitis?
During the medical evaluation, the doctor will inquire about the symptoms one is experiencing. They will then perform a physical examination to assess any warmth or tenderness in the shoulder. To evaluate the range of motion, they will gently move the patient’s arm in various directions.
An imaging test, such as an X-ray, might be conducted to obtain a clear view of the bones and exclude other conditions like arthritis that share similar symptoms. Additionally, an MRI (magnetic resonance imaging) may be used to determine if the subacromial bursa is filled with fluid.
If there are suspicions of an infection causing the bursitis, the doctor may order a blood test. In certain situations, the doctor may also drain fluid from the bursa for testing and further evaluation.
What Is the Treatment for Subacromial Bursitis?
The treatment for subacromial bursitis aims to reduce inflammation, alleviate pain, improve shoulder function, and address any underlying causes contributing to the condition. The specific treatment plan may vary based on the severity of symptoms, the individual's medical history, and the underlying factors involved. The following are the common approaches to treating subacromial bursitis:
-
Rest and Activity Modification: Initially, resting the affected shoulder and avoiding activities that exacerbate the pain is essential to allow the inflamed bursa to heal. Modifying activities that involve repetitive overhead motions can help prevent further irritation.
-
Ice Therapy: Applying ice packs to the affected area can help reduce inflammation and provide pain relief. Ice can be applied for 15 to 20 minutes every few hours during the acute phase of bursitis.
-
Non-Steroidal Anti-Inflammatory Drugs (NSAIDs): Over-the-counter medications like Ibuprofen or Naproxen can help reduce pain and inflammation. However, it is essential to use them as directed and consult a healthcare professional if there are concerns about potential side effects or interactions with other medications.
-
Physical Therapy: A physical therapist can design a tailored exercise program to improve shoulder strength, flexibility, and range of motion. These exercises can help in the recovery process and prevent future flare-ups.
-
Corticosteroid Injections: If the pain and inflammation are severe, a doctor may administer corticosteroid injections directly into the subacromial bursa. These injections can provide significant relief and reduce inflammation. However, their use is typically limited due to potential side effects, and they may not be appropriate for everyone.
-
Aspiration of the Bursa: In some cases, the doctor may use a needle to withdraw fluid from the swollen bursa. This procedure, known as aspiration, can help alleviate pain and reduce pressure in the bursa.
-
Antibiotics: If an infection is suspected as the cause of the bursitis, a course of antibiotics may be prescribed to treat the underlying infection.
-
Activity and Posture Modification: Correcting posture and avoiding repetitive overhead movements can prevent recurrent episodes of bursitis.
-
Surgery: In rare cases where conservative treatments fail, or there is an underlying structural issue causing bursitis, surgical intervention may be considered to remove the inflamed bursa or address other shoulder problems.
Conclusion
In conclusion, subacromial bursitis is a painful condition caused by inflammation of the subacromial bursa in the shoulder joint. Its symptoms include shoulder pain, limited range of motion, swelling, and tenderness. Treatment options range from rest, ice, and physical therapy to corticosteroid injections and, in severe cases, surgical intervention. Early diagnosis and adherence to a personalized treatment plan can lead to effective relief and improved shoulder function.
