What is Shoulder Bursitis?
Bursitis in the shoulder is an extremely common finding on ultrasounds and MRI scans.
A bursa is a fluid-filled sack or pouch that sits between 2 firm structures in the human body to assist with creating less friction, therefore more fluid movement of the body.
Bursa are extremely common and located all throughout the body.
When a bursa is rubbed, compressed and squashed beyond it's capacity, it can become irritated and inflamed. This is known as bursitis.
The shoulder has a large bursa, called the Sub-Acromial Bursa, which is located on the top of the ball of the socket (the humeral head), and between the ceiling (the acromion).
Most common symptoms of Sub-Acromial Bursitis:
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Pain when you raise your arm forwards
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Pain raising your arm sideways
- Pain to sleep, sometimes both on and off your sore shoulder side
- Pain that can be at the tip of your shoulder, though may radiate down the top half of your arm.
Why does Sub-Acromial Bursitis happen?
Shoulder Bursitis can occur for a wide variety of reasons.
The main cause is a change in usage and loading of your shoulder.
If your shoulder does what it normally does through out the day, then your risk of a developing a painful shoulder bursitis is low.
If you start to suddenly play 5 sets of tennis daily, when you haven't played much in the last 6 months, then this rapid increase in activity can become painful for the bursa.
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Does Having Sub-Acromial Bursitis On A Scan Matter?
Most often, it doesn't matter!
If we were to scan a large group or people who have zero shoulder pain, we'd see that the vast majority of these people has Sub-Acromial Bursitis on their scan! Remember, these people don't have pain!
The key is clinically distinguishing whether your shoulder pain is actually caused by bursitis, or by another structure in the shoulder, typically the rotator cuff tendons.
Sports Doctors in Essendon, and Sports Physiotherapists are experts in determining what is actually causing your shoulder pain, and what you need to do about it.
Often the rotator cuff tendons are the cause of your shoulder pain, and the bursitis can be a red-herring, though sometimes the bursa is the true cause of the pain.
It is also common for someone to have micro-instability in the shoulder, which means the ball moves just 2-3mm extra in the joint, and this poorly controlled motion can compress and irritate the sub-acromial bursa, causing bursitis.
What Can You Do To Fix Shoulder Bursitis?
Typically we will organise an ultrasound scan to determine the extent of the bursitis and the exact location. Ultrasound scans by an experienced radiologist or sports doctor can very accurately assess the area and provide significant details that are vital in creating an effective treatment plan.
Conservative Management Of Shoulder Bursitis::
This is how you fix the majority of shoulder sub-acromial bursitis.
The involves soft tissue therapy and specific exercise strengthening via a sports physiotherapist who understands shoulders intimately.
Improving shoulder strength, to control the ball in the socket is paramount, and is the best long lasting treatment of shoulder bursitis.
Injection Therapy For Shoulder Bursitis:
Cortisone (steroid) injection is a common treatment for sub-acromial bursitis, and has been shown to be effective for the right person with a correct diagnosis.
You must have severe bursitis showing up on your imaging, serious pain, or have not gained relief following a physiotherapy-led shoulder rehabilitation program that targets bursitis.
We recommend a sub-acromial bursa injection if it is necessary, and to have the injection guided by ultrasound by a recognised sports doctor who specialises in this area.
Surgery For Shoulder Bursitis:
For persistent cases that do not resolve, then surgery can be recommended. The surgery involves removing the bursa and is shown to have a high success rate to resolve the symptoms, as long as the patient pursues the appropriate post operation physiotherapy strengthing program.
Like any surgery it does have inherent risks but for cases that don't respond to conservative management or injection therapy then this is an option that can be considered in the nasty recalcitrant cases.
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If you suffer from shoulder bursitis pain then we can help!
At our Essendon clinic, we can accurately assess and diagnose the cause of your pain through our experienced practitioners and referral partners.
We have excellent relationships with the best radiologists in Melbourne and have a Sports Doctor on site who can provide injection therapies if required.