What is Subacromial Bursitis?

Subacromial bursitis is an inflammation that causes intense shoulder pain which worsens when moving the arm.

What Causes It?

Subacromial bursitis occurs when the small fluid-filled cushions (bursa) that sit between the shoulder bones, muscles and tendons swell and become inflamed. The inflammation can happen suddenly due to a shoulder injury or gradually due to overuse of the shoulder muscles.

People at risk of subacromial bursitis include:

Jobs Involving Repeated Overhead Lifting Or Forceful Pulling.
Sports Involving Repeated Throwing, Pitching Or Swinging.

Symptoms

Here are some common signs that can point to subacromial bursa:

  • Pain in the shoulder
  • Shoulder stiffness
  • Pain spreading down the arm towards the elbow or wrist
  • Worse pain when reaching behind the head (washing hair) or lifting the arm above the shoulder (reaching for a shelf, swimming).
  • Pain when lying on the shoulder
  • Redness or warmth on the shoulder

How is it diagnosed?

  • Several questions will be asked about the shoulder pain (location, intensity, aggravators/relievers)
  • A physiotherapist will do a few simple tests to see the strength and movement of the shoulder joint.

While the above steps can quickly diagnose subacromial bursitis, ultrasound or x-ray scanning may be performed to confirm. 

Common Types of Bursitis

  • Inflammatory Bursitis Is When The Shoulder Cushion Becomes Inflamed Due To Overuse.
  • Calcified Bursitis Is When Bone Forms In The Shoulder Cushion Due To Chronic Or Recurrent Bursitis.
  • Septic Bursitis Is When There Is An Infection In The Shoulder Cushions.

Tips and tricks for managing daily activities

  • First 1-2 weeks: avoid using the sore arm. Continue to use the opposite arms without increasing the pain.
  • After 1-2 weeks: Start to use both arms without increasing the pain.
  • Avoid activities that make the pain worse.
  • Keep regularly used items at home or work below shoulder height.
  • Sleep on the opposite shoulder.

Treatment

  • Steroid injection
  • Anti-inflammatory medication

Physiotherapy

  • Education to manage pain and inflammation
  • Simple exercises (stretches, strengthening) to avoid permanent stiffness and weakness

How long until I get better?

The time of treatment may vary from patient to patient, but in most cases, the symptoms improve within a few months of treatment. Getting early treatment means you can avoid long-term joint problems.

Take home message

  • Subacromial bursitis is an inflammation that causes shoulder pain, usually gradually.
  • At first, give time for the swelling and inflammation to go down before using the sore arm.
  • Good posture can help to relieve symptoms.
  • A physiotherapist can give exercises that will help with the symptoms and prevent permanent weakness and stiffness.
  • Early treatment means permanent damage to the joint can be avoided.
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