Subacromial bursitis

What is subacromial bursitis?

Subacromial bursitis is an inflammatory condition that occurs in the shoulder joint when the bursa, the structure that protects the tendons from excessive friction on the acromion bone, becomes inflamed. Common symptoms of this condition include shoulder pain, especially when raising the arm or sleeping on the affected shoulder, shoulder weakness, and difficulty moving the arm at certain angles.

What causes subacromial bursitis?

The most common cause of subacromial bursitis is repetitive overuse of the shoulder, especially during work activities (performing activities that involve repeatedly raising the arm overhead) or sports that involve repetitive arm movements, such as lifting weights, playing tennis, or throwing a baseball.

Other possible causes include:

Trauma: A direct blow to the shoulder, a fall, or an awkward movement can cause acute inflammation of the bursa.

Rotator cuff injuries: These can be associated with inflammation in the subacromiosubdeltoid bursa.

Biomechanical or postural alterations:

• Subacromial impingement: This is one of the most common causes. It occurs when there is a narrowing of the space between the acromion and the rotator cuff tendons, which compresses and rubs against the bursa. This can be due to the shape of the acromion (which may be curved), calcium deposits in the tendons (calcific tendonitis), or thickening of the tendons.
• Poor posture: Maintaining an incorrect posture for prolonged periods, such as having the shoulders hunched forward, can contribute to friction and inflammation.
• Muscle weakness or imbalance: A change in the function of the shoulder muscles, such as joint instability or scapular dyskinesia (abnormal movement of the scapula), can increase pressure on the bursa.

Degenerative processes and age: With aging, the body's tissues, including bursae and tendons, become less elastic and more prone to inflammation. The resistance of synovial bursa tissue to repeated trauma decreases after age 40.

Systemic inflammatory diseases: Conditions such as rheumatoid arthritis, gout, or psoriatic arthritis can cause inflammation in the subacromial bursa.

Infections: Although less common, a bacterial infection (septic bursitis) can inflame the bursa, especially in people with open wounds in the area or with certain diseases (diabetes, alcoholism, etc.).

How is subacromial bursitis diagnosed?

Subacromial bursitis is diagnosed through a medical history and physical examination. The doctor may look for symptoms such as shoulder pain, arm weakness, and difficulty moving the shoulder. Plain radiography cannot diagnose subacromial bursitis, but it helps rule out other clinical conditions. Ultrasound and MRI are the most useful diagnostic tests for diagnosing subacromial bursitis.

How is subacromial bursitis treated?

Treatment for subacromial bursitis may include a combination of noninvasive and invasive therapies. Some treatment options include:

• Physical therapy: to strengthen the shoulder and scapula muscles, improving posture and mobility.
• Stretching exercises to relax shortened and overworked muscles.
• Ice cream application to reduce inflammation.
• Ultrasound-guided injections of corticosteroids and anesthetics to reduce pain and inflammation.
• In extreme cases that do not improve with conservative treatment, surgery may be used.

It is important to note that treatment for subacromial bursitis may also include preventative measures to avoid future injuries and recurrences.

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