Shoulder bursitis, also known as subacromial bursitis or impingement syndrome, is a condition characterized by pain and inflammation in the bursa of the shoulder. The bursa is a fluid-filled sac present between the bone and soft tissue that acts as a cushion and helps to reduce friction during movement. Usually, it is the result of repetitive overhead use of the arm but can occur spontaneously as we age due to gradual deterioration of our rotator cuff. Rarely in younger patients it may be the result of trauma.
Symptoms of Shoulder Bursitis
The most common symptom of shoulder bursitis is pain, particularly with overhead use of the arm or in certain posiitons. Other symptoms can include:
- Night pain and waking
- Swelling
- Decreased mobility/stiffness
- Tenderness and muscle weakness
Diagnosis of Shoulder Bursitis
Your doctor will review your medical history and symptoms and a physical examination of the shoulder will be performed. Your doctor may also recommend the following diagnostic tests:
- X-rays: During this study, high-energy electromagnetic beams are used to produce images of the bones
- MRI Scan: An imaging study that uses a large magnetic field to detect damage to the soft tissues and tendons. It is the best imaging modality for the shoulder
- Ultrasound: This study uses high-frequency sound waves to produce images of the superficial soft tissues of the shoulder and can identify fluid accumulated in the bursa.
Treatment for Shoulder Bursitis
Treatment for shoulder bursitis is based on the severity of the condition and is mainly to relieve pain and inflammation. Common therapeutic measures include:
Non-surgical Treatment
- Rest: Avoiding activities that can aggravate symptoms and resting may help to relieve inflammation.
- ICE therapy: You will be advised to apply ice, compression, and elevation to reduce inflammation and pain.
- Medications: Your doctor will recommend non-steroidal anti-inflammatory drugs (NSAIDs) as needed to reduce swelling and pain.
- Cortisone injections: This can be very effective at eliminating the inflammation in the bursa and providing symptomatic relief.
Physical therapy: Your doctor will recommend special exercises and other techniques to relieve pain and improve your shoulder mechanics to stop the impingement from happening
Surgical Treatment
If non-surgical methods are unsuccessful, surgery may be recommended. This may include:
- Bursectomy: The bursa is removed arthroscopically through tiny incisions.
- Acromioplasty: A part of the acromion is removed to provide space for the inflamed rotator cuff tendons.