Description, Causes and Risk Factors:
Inflammation of the subacromial bursa lying between the acromion above and the rotator cuff below; may be continuous with the subdeltoid bursa.
Subacromial bursitis is usually an overuse problem. The bursa is a fluid filled sac that is supposed to act as a shock absorber and lubricant for the tendons and shoulder joint. When the bursa and/or tendons get inflamed, the tissues swell and get stuck between the ball and socket shoulder joint and the outer, upper tip of the shoulder blade. Baseball pitchers and other “throwing” athletes are often plagued with this problem.
However, this can happen to just about anybody whether or not they participate in a repetitive shoulder movement activity. As we age and arthritis starts to set in, the space for the bursa and tendon narrows. This makes us more susceptible to pinching, inflammation and pain.
Overuse of the adjacent shoulder.
Degeneration of muscle tendons.
Adjacent inflammation of the supraspinatus tendon.
Glenohumeral instability (excessive movement of the joint) - Degeneration of the acromioclavicular (AC) joint.
Tears of the surrounding rotator cuff.
Impingement by the coracoacromial ligament.
Impingement on the posterosuperior aspect of the glenoid.
Upper extremity muscle weakness.
The Athlete is more prone to this injury if they overuse the shoulder particularly if the arm is at or above shoulder level. Or if the athlete has had a rupture of the supraspinatus tendon.
Pain down the arm, not past theelbow.
Difficulty raising the arm up overheador behind the back.
Possible weakness (related to pain).
Pain in the shoulder.
There are few time tested ways to diagnose the subacromial bursitis.
X-ray images- The images of acromial anatomy, bone spurs and arthritis help in further diagnosis. The layers of calcium in subacromial space can also trigger same pain and visualization of its present condition is possible through x-ray test only.
MRI scan- An MRI scan reveals the accumulation of fluid in bursa.
You may have been referred for an EMG to make sure there wasnot a pinched nerve in your neck or shouldercausing the symptoms.
Clinical tests- These tests will be performed by your therapist to make sure that the pain that you have in your shoulders is due to subacromial bursitis and not due to rotator cuff. Both of these conditions have same patterns of pain. With the help of treatment direction test, the therapist will diagnose the cause of your pain.
Initial management of subacromial bursitis involves immobilization with a sling and NSAIDs.
For pain that remains disabling after 72 hours, steroid injection of the bursa may be indicated.
Intrabursal steroid injection may be considered as initial treatment of some patients, especially those for whom daily NSAID is not favorable (some cardiovascular or renal disease).
If the bursa is believed to be infected, fluid may be aspirated with the guidance of imaging and the fluid can then be analyzed for organisms. It may be possible to debulk a calcific deposit by aspiration as well.
It is rarely necessary to surgically remove the bursa.
Physical therapy modalities including strengthening and range of motion exercises can aid in recovery.
Ice, heat, and rest should be utilized until acute pain subsides.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.You may also read about another disease: Pes Anserine Bursitis
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