What is bursitis of the shoulder?
An inflammation of the bursa of the shoulder (subacromial bursitis) is one of the most common causes of shoulder pain. A bursa is a small fluid-filled sac around the shoulder joint. Its job is to ensure that the shoulder can move smoothly. If this bursa becomes irritated it may swell up and on certain movements can become trapped. This can be very painful.
The cause is normally overuse of the shoulder, e.g. activities in which the arms are raised above the head or scrubbing the floor. A fall or lifting incorrectly may cause pain. Sometimes the symptoms develop spontaneously and no cause can be found.
Bursitis also often develops due to rheumatic disease or accident. Bursitis may accompany a tear in one of the tendons of the shoulder muscles.
Signs and symptoms
The pain is caused when the bursa becomes trapped. The pain can be either in the shoulder on lifting or turning the arm or it can radiate to the elbow and/or the neck. At night too, lying on the affected shoulder may be painful. The symptoms occur mainly during the activities of daily living such as getting dressed or brushing the teeth.
How is bursitis of the shoulder diagnosed?
The diagnosis is made on the patient's pattern of symptoms. When carrying out physical examination for shoulder problems, there are three useful shoulder tests: raising the arm out to the side, holding the arm along the body and turning it outwards, and bringing the arm over to the unaffected shoulder horizontally. In addition a neurological examination has to be done to exclude a disc prolaps of the neck.
Do I need additional examinations necessary for me?
- Blood tests on suspicion of systemic diseases such as rheumatoid arthritis.
- If symptoms persist for a long time: X-rays, ultrasound and MRI scan.
- A bone scan if a tumour is suspected.
What are my treatment options?
Interventional pain treatment
- Local injection of the shoulder bursa