Subacromial bursitis is an inflammation of one of the protective bursas or sacs located in the rotator cuff, a set of tendons involved in controlling movement of the shoulder. This condition will lead to pain, stiffness, and weakness in the shoulder. Treatment usually involves rest and gentle exercise until the inflammation resolves and the patient can resume normal activities. Straining the shoulder by attempting to work it too early can result in further damage to the rotator cuff and surrounding structures.
Cases of subacromial bursitis involve the sac surrounding the supraspinatus tendon, an important part of the rotator cuff. As the sac swells, it limits movement of the tendon. The patient may notice mild pain and swelling initially, proceeding to more intense pain and stiffness. The range of motion in the shoulder is typically limited and the patient's shoulder may be hot and tender to the touch.
The source of the injury is usually deposition of crystals around the joint, as seen in conditions like gout, or inflammation caused by autoimmune disease. Immediate treatment involves resting the shoulder to avoid exacerbating the inflammation and applying ice and heat as needed to increase patient comfort. Patients will also be given gentle physical therapy exercises to stretch the shoulder during the healing process. For people like athletes, this is important, as it will help retain muscle strength and flexibility while the athlete cannot work out.
If subacromial bursitis is causing extreme pain, a doctor may prescribe pain management and anti-inflammatory drugs to reduce the swelling in the shoulder if more conservative treatments do not work. Steroid injections into the shoulder can be used for extreme cases. The patient may also be evaluated as a potential surgical candidate if the doctor feels surgery should be considered as a treatment option, usually when the rotator cuff is clearly torn or otherwise compromised in addition to having subacromial bursitis.
Patients with subacromial bursitis should not pursue massage therapy on the shoulder during healing, as massage can cause pain and may increase the inflammation. It is also important to rest until fully cleared by a physician. As the shoulder starts to improve, it can be tempting to return to normal activities, but this can endanger the rotator cuff and cause a flareup of the inflammation. A doctor needs to thoroughly examine the shoulder and interview the patient before an approval to get back to work or exercise will be granted.
