Subacromial Bursitis | Shoulder Pain | Dr Ayyappan V, Bangalore

Sub acromial Bursitis

Bursitis is a condition where the bursa becomes inflamed or irritated and causes pain. The bursa is a tiny sac filled with lubricating fluid, located between tissues such as bone, tendons, muscles and skin and help in reducing rubbing and friction. Bursitis commonly occurs near joints that perform repetitive motions like shoulder, elbow, hip and knee.

It is estimated that there are over 150 bursae in our body.

Sub acromial Bursitis is an injury or inflammation of the shoulder bursa. Shoulder has many bursae but the most commonly inflamed one is sub acromial bursa and hence shoulder bursitis is often called as sub-acromial bursitis. Sub-acromial bursa lies between the humerus and the acromion. Normally, the tendons and bursa slide easily between these two bones. But because of arthritis, trauma etc the space between these bones become narrow causing irritation in the bursa leading to inflammation pain, thus bursitis.

What are the symptoms of Sub acromial bursitis?

Symptoms of bursitis vary depending on how they are caused. Common symptoms include pain in the shoulder, inflammation, feeling of warmth in the area and limited range of motion. Pain with specific movements like taking the arm away from the body and activities reaching overhead. In certain cases, the pain refers down the arm to the elbows and wrists. In case of infected bursitis, occasionally there will be fever.

What causes sub acromial bursitis?

A bursa can become inflamed due to an injury, infection or an underlying rheumatic condition. It normally occurs in people involved in doing repetitive overhead activities like painting. If bursitis is caused due to an infection, it is called septic bursitis.

Certain risk factors have been reported for getting Shoulder Bursitis:

Gout
Diabetes
Uremia
Rheumatoid Arthritis
Bad posture
Not properly recovering from a previous shoulder injury
Traumatic bursitis are commonly seen in athletes playing sports like football, basketball, swimming etc

How is sub acromial bursitis treated?

It is treated with conservative non-surgical methods like

Rest
Ice
Non-Steroidal Inflammatory Drugs
Antibiotics in case of septic bursitis
Cortisone Injections (in case of severe cases)
Aspiration of the bursa
Physiotherapy
Surgery

Surgery is rarely opted for treating Shoulder Bursitis, but occasionally it is required for chronic cases where the pain does not subside using conservative non-surgical methods of treatment.

The most common surgical treatment is an incision and drainage wherein the fluid present in the inflamed bursa is drained out. Sometimes, it is required to excise the entire bursa surgically (Bursectomy).

Can sub acromial bursitis be prevented?

There are certain precautions that can be taken, which may help avoiding getting any shoulder problem.

Taking frequent breaks while playing any sports that require overhead movements
Practice stretching exercises
Take care of your posture always
Avoid making body exposed to extreme cold weather

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Q&As on Subacromial Bursitis

What causes subacromial bursitis?

Bursitis is an inflammation of the bursae. Bursae are small fluid-filled spaces around the joints that cushion the bones, tendons, and muscles. The subacromial bursa is located in the shoulder joint.
Subacromial bursitis is a painful condition and the most common type of bursitis.
It is most often caused due to frequent repetitive movements of the shoulder. Activities that involve throwing or overhead motion of the arms like in case of baseball players, painters, carpenters, etc.
Acute injury or accident can also cause subacromial bursitis.
Individuals with diabetes, rheumatoid arthritis, gout, or other systemic diseases are more prone to develop subacromial bursitis.
It is also common in older individuals as a part of the normal wear and tear process of the body associated with aging.
A bacterial infection of the bursa can also cause bursitis. It would result in painful swelling with redness over the shoulder. The shoulder might also be warm to touch.

What happens if subacromial bursitis is left untreated?

Usually, if there is minor pain and discomfort due to subacromial bursitis, it can be treated with at-home remedies. Rest and hot or cold compression are enough to heal bursitis over a few weeks.
However, not taking any precautions or treatment would only make it worse over time. Untreated subacromial bursitis can cause chronic pain and inflammation. This is due to a permanent thickening or enlargement of the bursa.
Due to pain and discomfort, individuals avoid doing the movements that cause it. In the case of untreated bursitis, there is a prolonged reduction in the use of the shoulder joint. This leads to loss of muscle or muscle atrophy in the shoulder region.
If the cause is an infection, it can spread to cause sepsis, which is a life-threatening condition.

What are the signs and symptoms of shoulder bursitis?

Shoulder bursitis is due to inflammation of the subacromial bursa. The subacromial bursa is a fluid-filled space that cushions the area between the rotator cuff (a group of muscles in the arm) and the acromion (the highest point of the shoulder blade).
Shoulder pain is the most common symptom of bursitis. It can be sudden or gradual. It can be experienced as a dull ache, sharp pain, or just tenderness.
An inability to move the shoulder
Shoulder stiffness
Pain at night when sleeping on the affected shoulder
Difficulty and pain with overhead movement of the arm.
Redness and swelling of the shoulder. It may be warm to touch.

How is subacromial bursitis treated?

Depending on the severity of the symptoms, there is a range of treatment options available.
Firstly, giving the affected shoulder joint enough rest is advised. Patients are asked to avoid movements that caused the pain in the first place, like the overhead movement of the arm.
Medication (like painkillers and antibiotics) is prescribed for the pain and infection.
Physical therapy tailored to an individual’s condition is advised.
In case of extreme pain, corticosteroid injections are given to the joint. They help reduce inflammation and help with the pain.
Lastly, in rare cases, arthroscopic surgery might be advised if none of the above treatment options work. The doctor removes damaged tissue that is causing the pain.

Is bursitis a form of arthritis?

Although both bursitis and arthritis have similar characteristics, they are different diseases. Arthritis consists of chronic diseases like osteoarthritis or rheumatoid arthritis. Bursitis, on the other hand, is a temporary condition that is caused due to injury, infection, or overuse.

Sub Acromial Bursitis