Shoulder Bursitis (Subacromial bursitis)

What is Bursitis of the Shoulder.

Subacromial bursitis is a common condition affecting the shoulder, characterised by inflammation of the bursa located around the rotator cuff and below the acromion. In layman’s terms, Subacromial bursitis is a name given to inflammation around the tendons encircling the shoulder joint which make up the rotator cuff. The tendons produce fine movement of the shoulder and stabilise the joint to allow the main powerhouse of the shoulder (the deltoid muscle) to produce the main force. Inflammation of the tendons or the lining of the tendons (the bursa) can lead to pain usually felt down the side of the arm and worse with movement, particularly in the painful arc position from waist height

The terms bursitis, tendinopathy/tendinitis or rotator cuff syndrome are often used interchangeably, and relate to inflammation and ageing of the tendon and its lining.to above shoulder height.

This condition can lead to significant shoulder pain and discomfort, particularly during overhead activities. Dr Nimon at Glenelg Orthopaedics, specialises in diagnosing and treating this condition, and aims to provide Quality and Personalised treatment for shoulder bursitis.

Symptoms of Subacromial Bursitis

Common Signs and Symptoms

Patients with subacromial bursitis often report a dull aching pain in the shoulder, especially when lifting the arm above the head and also noted when trying to sleep. The pain typically radiates down the side of the arm and may be accompanied by a clicking or grating sensation.

Risk Factors for Developing Subacromial Bursitis

Factors increasing the risk of developing subacromial bursitis include:

Age: Incidence increases with age due to wear and tear.
Occupation: Jobs requiring repetitive overhead movements.
Sports: Activities like tennis or swimming that stress the shoulder.
Familial history ( runs in families)
Previous Shoulder Injuries: Breaks can predispose to bursitis.

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Causes of Subacromial Bursitis

Common Causes

There are several factors that can lead to the development of shoulder bursitis:

Repetitive Motion: Frequent and repetitive overhead activities, often seen in athletes or certain occupations, can put excessive stress on the shoulder, leading to irritation and swelling of the bursa.
Injury: Direct impact or trauma to the shoulder, such as falls or blows, can cause immediate swelling and inflammation of the bursa.
Underlying Shoulder Conditions: Conditions that narrow the space within the shoulder joint , like rotator cuff tears, shoulder impingement syndrome, or acromioclavicular arthritis, can increase the likelihood of bursitis.
Others: Systemic inflammatory conditions such as rheumatoid arthritis can also predispose an individual to bursitis throughout the body including the shoulder.

It’s important to address these factors early with appropriate interventions, such as proper technique in sports and ergonomics at work, to manage and prevent shoulder bursitis effectively.

Diagnosing Subacromial Bursitis

Assessment by a Specialist Shoulder Surgeon

The diagnosis is usually easily made by taking a thorough history and performing a focused examination. As such Dr Nimon will perform specific movements to assess sites of pain and range of motion and strength in your shoulder.

Diagnostic Procedures

Surprising for many, but overall one of the most helpful tests is an X-Ray, to exclude arthritis or other issues. Imaging tests like ultrasound are often already ordered by the referring general practitioner and can demonstrate buristis or tendon tears whilst Dr Nimon may order an MRI, if more sensitive tests are required. These tests help in assessing the extent of inflammation and ruling out other conditions like rotator cuff tears.

Treatment Options

Non-Surgical Treatments

Most cases of subacromial bursitis respond well to non-surgical treatments, including:

Rest and activity modification to reduce stress on the shoulder.
Physiotherapy exercises to strengthen the rotator cuff muscles.
Pain relief medications and anti-inflammatory drugs.
On occassions, an ultrasound-guided corticosteroid injections for reducing inflammation may be used.nd can be helped by avoiding the painful position (the painful arc and overhead activities).
We don’t recommend that the patient sbe immobilised in a sling, and should only be used for temporary episodes of severe pain.

Surgical Treatments

In severe cases where non-surgical treatments are ineffective, surgery may be considered. Procedures like arthroscopic bursectomy (or acromioplasty) can provide relief by removing inflamed tissue or creating more space for shoulder movements, but is usually required where other pathogy exists such as AC joint arthritis, Rotator Cuff Tears, Labral tears or Biceps tendon tears.

Dr Nimon performs the surgery using key-hole or minimally invasive arthroscopic portals.

Rehabilitation and Physiotherapy

Post-treatment, rehabilitation plays a crucial role in recovery. Our physiotherapy program focuses on restoring shoulder strength and flexibility, gradually returning you to your normal activities.

Usually a sling is not required and early movement is encouraged, depending upon the associated pathology treated.