Shoulder bursitis or subacromial bursitis


What does shoulder bursitis or subacromial bursitis mean?

There are hundreds of bursae (bursa synovialis) in the human body; these are bladders containing synovial fluid.

They are mainly found between tendons , muscles and joints.
Their task is to reduce friction during movement and distribute the load evenly over the joint surfaces.

The friction that can be created between two tendons or between tendons and bones would cause injury, which the bursa prevent.
Bursitis is inflammation of a bursa and is one of the most common causes of acute shoulder pain .

The subacromial bursa is located between the acromion, deltoid and metatarsal muscle. The shoulder joints, elbows , knees and hip joints are most commonly affected by acute bursitis .
Bursitis occurs primarily on the right side, but left-handers are more likely to encounter this disorder on the left.
Bilateral bursitis is extremely rare.

They can be divided into two groups: hemorrhagic and inflammatory bursitis The first group is caused by direct trauma, causing the sac to fill with blood.
In turn, inflammatory bursitis can be chemical, septic (due to an infected wound), or overuse (due to constant friction of the tendon against the bursa, typical of athletes).

What are the causes of shoulder bursitis?

Shoulder bursitis is common in groups of people who perform a specific arm movement (throwers, house painters) and is often accompanied by tendinopathy of the metatarsal muscle ( tendinitis or tendinosis ) because both are related to the repetitive motions involved in physical activity .

Acute tendinitis tendinitis ) affects almost exclusively athletes, while bursitis can also affect predominantly sedentary people and any age group.
Usually, the cause of shoulder bursitis is overuse of the tendons; in fact, it mainly affects patients who already suffer from inflammation of the tendons of the metastases and biceps biceps, while the bursitis of the heel and elbow are actually exclusively of traumatic origin.
A traumatic origin is also possible as a result of a bruise (contusion).

 What are the Symptoms of Shoulder Bursitis?

Bursitis produces inflammation and pain , and redness and warmth can also be felt in the acute phase; in the shoulder joint, however, the bursa lies deep and is not visible like that in the superficial position at the elbow.
The most important feature is that the shoulder pain does not occur during movement, but at night after a rest period of at least 30 minutes.
The movement relieves the symptoms until they subside completely, and the pain is rarely unbearable.
The symptoms of bursitis only become apparent after a period of restperceived and are caused by the accumulation of fluid (effusion) in the bursa, which presses against the parts of the joint and impedes movement.
In severe cases, you see patients who cannot get their hands to their face, such as to eat.

After a few movements, the fluid in the joint is distributed and the pain disappears.
This painful syndrome often occurs in combination with other ailments: inflammation of the supraspinatus tendon, tendon injuries, calcium deposits , dislocations and post-traumatic inflammation.

How is shoulder bursitis diagnosed?

Usually, bursitis is easy to diagnose because of a consistent  inflammatory edema  (elbows and knees). The shoulder joint, especially the  subacromial  lie

but deep. Internal inflammation cannot be recognized by external observation

ground, then in addition to the physical examination, magnetic resonance ,  TC  or sonography can bring clarity. An X-ray examination only shows the bones, so it is of little use in the differential diagnosis of subacrominal bursitis. It is common for shoulder pain to be accompanied by tendinitis, rupture of the metatarsal tendon, shoulder arthrosis, etc.

What can you do? Which therapy is suitable for shoulder bursitis?

Immobilization plays the most important role in healing bursitis; if the activity that led to the inflammation is not stopped, the condition can only worsen.

In the acute phase (the first two days), cold packs or ice should be applied 3 times a day for 20 minutes each.
Doctors often recommend taking nonsteroidal anti-inflammatory drugs (NSAIDs) to resolve this pain syndrome.

If the bursitis does not heal within a week, physical therapies can achieve excellent results because, unlike drugs, they act locally; shock waves, laser CO2 and ultrasound therapy are particularly effective .
Myofascial manipulation is very effective in treating shoulder bursitis.

In stubborn cases, the doctor can place local cortisone or hyaluronic acid infiltrations  .

In more severe cases, the surgeon may remove the bursa arthroscopically (bursectomy); no incision is made, only three small holes through which the surgical instruments are inserted.

Natural remedies for shoulder bursitis

The natural forms of treatment include rehabilitation exercises in the gym with the widest possible movements to restore the joint’s lost elasticity. It is important to carry out Codman’s pendulum movement in order to separate the joint, ie to remove the joint heads from one another. This movement gives more space to the thickened bursa that is compressed between the acromion and the head of the humerus. Kinesio taping for contractures, inflammation, bruises and edema on the shoulder

Effect: tension-relieving-draining. Shape: two fan-shaped stripes. Length: 25cm. Attach the front fan while stretching your arm backwards, the back fan while your arm is stretched forward. Avoid bony prominences such as the scapula acromion.

To strengthen the muscles , one should first wait for the symptoms to completely subside, but if there is an imbalance between the posterior muscles that extend the shoulder and the anterior flexors, specific physical therapy exercises should be performed to correct them. Can cause bursitis If none of these measures cures, the orthopaedist might recommend surgery (at the earliest 8 months after the onset of the inflammation).

Tennis and swimming should be avoided because they can worsen discomfort and inflammation.

Acupuncture is not very effective for shoulder bursitis.
In the acute phase, the front and back of the shoulder can be smeared with green clay to relieve the inflammation.

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