Subacromial bursitis

Subacromial bursitis is a type of shoulder problem that is common in athletes, sportspersons and people involved in laborious tasks. Get detailed information about the disease, including its causes, symptoms, diagnosis, and treatment options.

Subacromial bursitis Definition

It is a condition caused by an inflammation of the Subacromial bursa that separates the superior surface of the supraspinatus tendon from the deep surface of the deltoid muscle. This bursa assists the movement of the supraspinatus tendon of the rotator cuff in activities such as overhead work. This type of bursitis usually takes place after an injury, such as a fall or as a result of unaccustomed over-usage of the shoulder joint or shoulder muscles.

The Subacromial bursa is a huge structure which lies just beneath the acromion and coracromial ligament. It is not connected with the shoulder joint, unless the supraspinatus tendon gets tattered. When the arm is at the side, the bursa protrudes in a lateral direction from underneath the acromion; but it rolls under the bone when the arm is abducted.

Subacromial Bursitis Symptoms

The symptoms of this form of bursitis actually begin after a few weeks or some months. Pain is the main problem. The symptoms of Subacromial bursitis are as follows:

Picture of Subacromial bursitis

Picture 1 - Subacromial bursitis

  • Gradual start of symptoms over weeks and months.
  • Pain on the outer part of the shoulder.
  • Pain, which might cover the arm slowly towards the elbow or wrist.
  • Worsening of pain while lying on the affected side.
  • Worsening of pain when the arm is lifted above head.
  • Sensation of a painful arc movement. The pain is felt between 60-90 degrees of arm moving upwards and outwards. There is minimal pain on the side and when the arm is lifted at 90 degrees.
  • Painful sensations while carrying out activities such as washing hair, or when trying to reach a high shelf in the cupboard.

Subacromial Bursitis Causes

Subacromial Bursitis can be caused by repeated minor trauma such as over-usage of the shoulder joint and muscles or a significant trauma such as a fall. It generally occurs due to repetitive or prolonged activities when the Subacromial bursa gets strained due to repetition of activities such as those which involve arm elevation, rotating the shoulder, lifting, pushing or pulling movements. Placing weight on the arm or lying on the affected side also leads to pain. At times, the condition may appear suddenly because of a blow to the point of the shoulder or a fall or elbow or outstretched hand. An acromion bone, degenerative alterations to the AC joint, bony spurs may make a patient prone to Subacromial bursitis.

Subacromial Bursitis Diagnosis

It is often difficult to differentiate between the pain caused by rotator cuff injury and that caused by Bursitis. This is because both demonstrate a similar pain in the front or side of the shoulder. Subacromial bursitis can be painful with resisted abduction or when the bursa is pinched as the deltoid contracts. Usually a detailed subjective and objective examination is done by a physiotherapist which is sufficient to diagnose the Subacromial bursitis. An ultrasound test is the general examination carried out to identify the Subacromial bursitis. Other investigations such as an X-ray, MRI or CT are often required to assist in the diagnosis and evaluation of the severity of the condition.

Subacromial Bursitis Treatment

This condition requires immediate treatment to ensure speedy recovery. Ignoring symptoms or continuing with activities that caused it in the first place will only make it a chronic condition.

The patient must firstly stop activities that aggravate the pain and apply ice over the affected area. Relief may also be brought by manual hands-on therapies from a physiotherapist, such as:

Image of Subacromial bursitis

Picture 2 - Subacromial bursitis Image

  • Massages
  • Manipulation
  • Electrotherapy
  • Joint mobilization
  • Trigger point releases
  • Stretches
  • Dry needling

Pain-killers or anti-inflammatory medications can also work wonders. Strapping or tapping of the shoulder and acupuncture are other possible treatment options. Injection of a steroid drug can also help relieve pain and swelling associated with this disorder.

Surgical intervention is rarely required in cases of this disorder. Surgery is opted for when conservative treatments do not work. Minimally invasive procedures, such as arthroscopic elimination of the bursa, allow a doctor to inspect the shoulder structures directly. This offers the physician an opportunity to remove the bone spurs and repair any tears in the rotator cuff.


By    Last updated September 26th, 2012

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