Shoulder pain is a common pain felt by a lot of people and one of the common shoulder problems is bursitis. Shoulder bursitis is the irritation or inflammation of a bursa/e around the shoulder joint. Bursa is a fluid-filled sac that reduces irritation, friction, and rubbing between tissues like bone, skin, muscle, and tendon. There are several bursa in the shoulder. The subacromial bursa is the most commonly irritated bursa in the shoulder.
Causes of Shoulder Bursitis
Bursitis around the shoulder area can have one or more causes. It can be caused by a minor trauma like overusing the shoulder muscles and joint or injuries such as a fall. It may also be caused by an underlying rheumatic condition. Here are the possible causes of bursitis:
- Shoulder trauma or injury
Your shoulder bursa can become inflamed simply by lifting a bag of groceries for a distance and this could lead to shoulder bursitis. Bumping your shoulder on a hard surface or falling can cause the bursa to fill with blood and the lining of it to become inflamed. The body may reabsorb the blood but the inflammation stays there which results in bursitis symptoms also known as traumatic bursitis.
- Rheumatic conditions and aging
People who age tend to develop rheumatic conditions as their soft tissues become more fragile which may be a result of wear and tear. Advancing of age also increases the chances of developing bursitis in the shoulders even if it isn’t caused by rheumatic conditions.
- Repetitive pressure on the shoulder
Shoulder bursitis is often caused by having frequent minor traumas that can result in the same problems but as a major trauma. Athletes and workers who often need to lift their arms overhead are likely to be at risk of developing shoulder bursitis over time. These may include tennis players, badminton players, baseball pitchers, rowers, swimmers, painters, baggage people, and wallpaper hangers.
- Poor Posture
Hunching the shoulders reduces the space between the glenohumeral shoulder joints and the acromion allowing the soft tissues in between them to get squeezed and become inflamed or irritated.
- Bacterial infection of a bursa
Septic bursitis is an infection of the bursa. There are certain diseases and medicines that affect people’s immune systems that make them prone to having septic bursitis.
These conditions include HIV/AIDS, cancer, lupus, , chronic obstructive pulmonary disease, and alcoholism.
Symptoms of Shoulder Bursitis
These are the common symptoms of shoulder bursitis:
- Pain in the shoulders that may be mild and build up gradually or appear all of a sudden which might already be severe. The pain is usually felt when lifting the arms overhead but may be felt even while at rest over time.
- Adhesive capsulitis or severe loss of motion in the shoulder
- Pain that gets worse after doing a repetitive activity that involves the shoulders such as playing tennis, painting, or throwing a ball.
- Tenderness of the shoulder
- Radiating pain
- Weakening of the muscles in the shoulder
- Warmth and redness of the shoulder
- Feeling tired, sick, and feverish
- Pain that may spread to the arms up to the elbows and wrist
- Pain that gets worse when lying on the affected shoulder
Diagnosis of Shoulder Bursitis
Before diagnosing a patient with shoulder bursitis, the doctor must rule out other conditions that also cause shoulder pain. These are the different diagnostic tools that a doctor uses to diagnose shoulder bursitis:
- Patient Interview
The doctor asks about the patient’s medical history and the details of the symptoms felt by the patient including the pattern of the swelling and pain, and how the daily activities are affected.
- Physical Exam
The doctor examines the patient’s joints, the noted tenderness and swelling, and the points of pain. The doctor performs a series of physical tests like raising the hands over the head to assess pain and mobility.
- Ultrasound, x-rays, and MRI
The tests are done to see any abnormalities in the internal organs. X-ray can show abnormalities in the bone while ultrasound and MRI can show a more detailed view of the soft tissues and may also be used to detect abnormalities like swollen bursa or damaged muscle or tendon.
Treatment of Shoulder Bursitis
The treatment of shoulder bursitis is aimed at controlling the inflammation of the bursa. Here are the different ways to treat shoulder bursitis:
Avoid activities, postures, and movements that provoked the inflammation of the shoulder bursa and avoid anything that causes pain on the shoulder such as pushing, pulling, lifting and throwing.
- NSAIDS or Non-steroidal anti-inflammatory drugs
Ibuprofen, aspirin, and other drugs can decrease the
- Topical Medicines
These can come in sprays, creams, patches, and gels that can be applied directly on the skin on the part where the pain is felt.
Septic subacromial bursitis is treated with antibiotics. The type of antibiotics recommended by the doctor depends on the type of microorganism triggering the infection.
- Corticosteroid injections
If the symptoms of bursitis are not successfully treated with NSAIDs, rest, ice, and/or physical therapy, a doctor may recommend injection of corticosteroid to relieve the patient of the pain