Subacromial Bursitis

Subacromial bursitis is a common shoulder condition characterized by inflammation of the subacromial bursa, a small fluid-filled sac located between the rotator cuff tendons and the acromion, a bony prominence of the shoulder blade. This inflammation can result from repetitive overhead activities, shoulder trauma, or underlying shoulder joint conditions. Understanding the causes, symptoms, diagnosis, treatment, and prevention of subacromial bursitis is essential for effective management and relief of symptoms.

Causes

Subacromial bursitis often develops as a result of repetitive overhead activities or repetitive shoulder movements, such as lifting, reaching, or throwing. These activities can lead to friction and irritation of the subacromial bursa, causing inflammation and swelling. Additionally, shoulder trauma, such as falls or direct blows to the shoulder, can also lead to subacromial bursitis. Other contributing factors may include poor shoulder mechanics, muscle imbalances, or underlying shoulder joint conditions such as rotator cuff tears or shoulder impingement syndrome.

Symptoms

The symptoms of subacromial bursitis typically include:

• Shoulder pain, particularly with overhead movements or activities that involve raising the arm.
• Pain that radiates from the shoulder to the upper arm or down the side of the arm.
• Swelling and tenderness in the front or side of the shoulder.
• Pain and discomfort when lying on the affected shoulder.
• Limited range of motion in the shoulder joint, especially with movements such as reaching behind the back or lifting objects overhead.
• Pain at rest, particularly during the night, which may disrupt sleep.

Diagnosis

Diagnosing subacromial bursitis usually involves a comprehensive medical history review, physical examination, and imaging studies. During the physical exam, the healthcare provider will assess the range of motion in the shoulder joint, check for signs of inflammation or tenderness, and evaluate for any associated shoulder conditions, such as rotator cuff tears or shoulder impingement syndrome.

Imaging tests such as X-rays, ultrasound, or MRI scans may be ordered to visualize the shoulder joint and assess the extent of inflammation and any underlying structural abnormalities.

Treatment

Treatment for subacromial bursitis aims to reduce pain, inflammation, and swelling, and improve shoulder function. Conservative treatment options may include:

• Rest and activity modification: Avoiding activities that exacerbate shoulder pain and inflammation, such as overhead movements or heavy lifting, can help alleviate symptoms and promote healing.
• Ice therapy: Applying ice packs to the affected shoulder for 15-20 minutes several times a day can help reduce pain and inflammation.
• Nonsteroidal anti-inflammatory drugs (NSAIDs): Over-the-counter NSAIDs such as ibuprofen or naproxen may be prescribed to relieve pain and reduce inflammation.
• Physical therapy: A tailored physical therapy program focusing on shoulder stretching, strengthening exercises, and range of motion exercises can help improve shoulder mechanics, reduce inflammation, and prevent recurrence of symptoms.

In cases where conservative measures fail to provide adequate relief, or if the bursitis is severe, corticosteroid injections may be recommended to reduce inflammation and alleviate pain. In rare cases of persistent or recurrent subacromial bursitis that does not respond to conservative treatment, surgical intervention to remove the inflamed bursa (bursectomy) may be considered.

Prevention

Preventing subacromial bursitis involves maintaining good shoulder mechanics, avoiding overuse or repetitive overhead activities, and addressing any underlying shoulder joint conditions or muscle imbalances. It's essential to warm up before engaging in physical activities, use proper lifting techniques, and incorporate shoulder-strengthening exercises into your regular fitness routine to help prevent shoulder injuries.

Conclusion

Subacromial bursitis is a common shoulder condition characterized by inflammation of the subacromial bursa, often resulting from repetitive overhead activities or shoulder trauma. By understanding the causes, symptoms, diagnosis, treatment, and prevention of subacromial bursitis, individuals can work with healthcare professionals to effectively manage symptoms, reduce inflammation, and improve shoulder function. Whether through conservative measures or more invasive interventions, addressing subacromial bursitis promptly can help individuals regain comfort and mobility in the shoulder joint.