Subacromial Bursitis: A Comprehensive Guide to Shoulder Pain Relief

Definition:

Subacromial Bursitis is the inflammation of the subacromial bursa, a fluid–filled sac located between the rotator cuff tendons and the acromion(part of the shoulder blade). This bursa acts as a cushion, reducing friction during  arm movements.

Cause:

The primary cause is often repetitive overhead activities, leading to overuse and irritation of the bursa. Other contributing factors include:

• Trauma: Direct injury to the shoulder.
• Improper Biomechanics: Poor posture or movement patterns.
• Bone spurs: Acromial spurs can impinge on the bursa.
• Underlying Conditions: Rheumatoid arthritis or gout.

Clinical Features:

Patients typically experience:

• Gradual onset of shoulder pain.
• Pain worsens with arm elevation, especially overhead.
• Night pain, particularly when lying on the affected side.
• Limited range of motion due to pain.

Signs & Symptoms:

Key indicators include:

• Localized Tenderness: Pain when pressing on the top of the shoulder.
• Painful Arc: Pain between 60 and 120  degrees of arm abduction.
• Weakness: Perceived weakness due to pain, not true muscle weakness.
• Clicking/Grinding: Less common, but can occur with severe inflammation.

Physiotherapy Management:

Physiotherapy is crucial for recovery. Management often includes:

• Pain Management: Ice application, modalities like ultrasound.
• Rest and Activity Modification: Avoiding aggravating activities.
• Stretching: Gentle exercise to restore range of motion.
• Strengthening: Progressive exercise for the rotator cuff and periscapular muscles.
• Postural correction: Addressing poor posture that contributes to impingement.
• Education: guidance  on proper body mechanics and activity modification.

complications:

Chronic Shoulder Pain: Persistent inflammation can lead to long-term irritation.

Reduced Range of Motion: Ongoing swelling may limit shoulder mobility.

Rotator Cuff Tendinopathy: Increased friction can irritate or damage the rotator cuff tendons.

Rotator Cuff Tear: Severe or long-standing bursitis may increase the risk of partial or full-thickness tears.

Shoulder Impingement Syndrome: Ongoing irritation can worsen impingement under the acromion.

Muscle Weakness: Due to pain inhibition, leading to reduced functional use of the arm.

Calcific Bursitis: Chronic inflammation may cause calcium deposits within the bursa.

Adhesive Capsulitis: Prolonged pain and limited movement can contribute to stiffness and capsular tightening.

Conclusion:

Subacromial Bursitis can be debilitating, but with appropriate rest, activity modification, and a structured physiotherapy program, most individuals experience significant improvement and return to their normal activities. Early intervention is key for optimal outcomes.

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