Shoulder Bursitis - Causes, Symptoms and Treatment

Shoulder pain is such a common situation that up to 70% of people have this type of pain at least once throughout their lives. Among the various possible causes of shoulder pain, shoulder bursitis to, also called subacromial bursitis or subdeltoid bursitis, is one of the most common.

Bursitis is what we call the inflammation of the bursa, also known as synovial bursa, which is a small bag filled with liquid which acts as a shock absorber, reducing the friction between muscles, tendons and bones around the joints.

In this article we will explain what is shoulder bursitis, what are its causes, symptoms, treatments available and ways of prevention.

Shoulder bursitis symptoms
Shoulder bursitis symptoms

The shoulder is one of the most complex joints of our skeleton, formed by three bones and many muscles, tendons and ligaments. The shoulder is a joint that allows movement of the multiaxial arm shape, allowing us a great range of motion. To facilitate sliding, reduce friction, soften the impact between the shoulder anatomical structures there is a bursa, which is a small bag with liquid lubricant, which in the specific case of the shoulder is located below the acromion (the upper end of scapula bone) and the deltoid muscle, which is why it is called subacromial bursa subdeltoid.

Coronal section of shoulder
Coronal section of shoulder
The bursitis of the shoulder, also known as subacromial bursitis, is a problem which arises when the subacromial bursa subdeltoid is ignited. Often, bursitis part of a table called shoulder impingement , which is a shoulder condition in which not only the bursa is inflamed but also the muscles that pass through the subacromial space present tendonitis.

The impingement and shoulder bursitis can be caused by several factors, including trauma or excessive and repetitive movements of the shoulder, such as volleyball players, swimmers, golfers, tennis players, gymnasts, bodybuilders, painters, gardeners, carpenters, employees cleaning or any other professional activity that requires frequent and repetitive movements of the shoulder.

The shoulder bursitis can also be caused by systemic inflammatory disease such as polymyalgia rheumatica, gout, rheumatoid arthritis, lupus, psoriatic arthritis, and scleroderma.

Symptoms of shoulder bursitis

Shoulder pain and difficulty moving the arm are the most common symptoms of subacromial bursitis and shoulder impingement syndrome.

The pain of bursitis usually be located in the upper arm over the deltoid muscle, and may radiate to near the elbow. The pain tends to start up slightly, if worsening over days or weeks. The pain of bursitis or impingement syndrome worsens with arm movement, especially when we try to lift it above the shoulder line. As time pain becomes present even with the arm rest. At night, the pain can disrupt sleep, especially at times when the patient sleeps with the body turned sideways, over the affected shoulder.

With the worsening of pain, the patient begins to limit his movements with the arm. Scratching the back, wear a jacket, zip a dress, close the bra or raising the arm above the head become very painful attitudes. As the patient feels pain, the tendency is that it progressively less use the affected shoulder. This restriction of the shoulder movements may lead to the emergence of a second problem which is adhesive capsulitis, also known as frozen shoulder. Explained adhesive capsulitis an article aside: capsulitis DUCT - Frozen Shoulder.

If the bursitis in shoulder is not treated in its early stages, the inflammation tends to become chronic and more difficult to resolve. Prolonged inflammation of the bursa can lead to deposition of calcium in it, which causes calcification, hardening and loss of its ability to protect the joint.

Diagnosis of shoulder bursitis

The diagnosis of shoulder bursitis and impingement syndrome is usually done after joint evaluation of the clinical history, physical examination and imaging examinations.

During the physical examination, the orthopedic surgeon will make some tests, moving your shoulder in various ways to try to identify what are the movements that cause more pain. Another test commonly used is the injection of intra-articular anesthesia. In the case or bursitis of the shoulder impingement, the use of anesthetics relieves pain and allows the patient to regain its normal range of motion. In the adhesive capsulitis, pain relief is not accompanied return movements.

Radiography of shoulder does not make the diagnosis of bursitis, but it helps to rule out other possible causes of pain in the shoulder, as injuries to bones or.

If after complete clinical evaluation orthopedists still unsure of the diagnosis, the best imaging study to evaluate the bursa and tendons is the MRI of the shoulder.

Treatment of shoulder bursitis

The initial treatment of bursitis is subacromial at rest, ice application and local pain control with analgesics and anti-inflammatories.

If the initial treatment did not provide satisfactory results within 72 hours or if the patient has contraindications to the anti-inflammatory use, the physician may choose to apply an intra-articular injection of corticosteroids. In many cases bursitis of the shoulder, a single intra-articular injection leads to healing of the frame.

After the pain management, physical therapy may be indicated for the patient to restore your muscle strength and range of shoulder movement.

In rare cases of chronic bursitis that do not respond to any treatment, surgery to bursa removal may be the solution.

Prevention of shoulder bursitis

After effective treatment of shoulder bursitis, some measures can be implemented to reduce the risk of recurrence:
  • Physical activity oriented professional to strengthen the muscles.
  • Stretches with professional guidance.
  • Avoid tasks that require repetitive movements of the shoulder for a long time.
  • If you can not avoid tasks that overburden the shoulders, look for at least make some breaks during day.
  • Avoid activities that cause shoulder pain.
  • Use both hands to hold tools or heavy objects.
  • Do not keep the fixed shoulder for long periods of time.
  • Search maintain good posture throughout the day, especially during the work.
  • Start rest and treatment so that the shoulder pain arise.

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