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Shoulder Bursitis

What is shoulder bursitis?

Bursitis of the shoulder (subacromial bursitis) develops when the area between the top of the arm bone and the tip of the shoulder becomes swollen and red. The rotator cuff tendons and a fluid-filled sac called the bursa are located between these bones. The bursa protects the tendons.

In normal circumstances, the tendons glide effortlessly across this gap. This area gets too narrow for regular movement in certain persons. This irritates the tendons and bursa, which become inflamed as a result. Inflammation causes the tendons and bursa to expand, thus reducing the available space for movement. This gap eventually gets too small for the tendons and bursa. They are pressed between the bones as they move. This is referred to as impingement, (Bursitis of the Shoulder | Cedars-Sinai, 2019).

What causes shoulder bursitis?

Bursitis is most frequently mostly caused by an injury. It may also be caused by infection.

Bursitis is often related to a variety of other conditions. These conditions include;  arthritis, gout, diabetes, and thyroid, (Bursitis of the Shoulder | Cedars-Sinai, 2019).

Many persons who have this pain have bones that are shaped differently than the bones of the majority of other people and have less space. Even minor thickenings of tendons or bursae might produce symptoms.

What are the symptoms of shoulder bursitis?

Often, an initial injury initiates the inflammation. Following that, the issue may deteriorate worse. Tendons and bursae get thickened as a result of this inflammation. The thickening then consumes additional space, further compressing the tendons and bursa. This results in increased inflammation and thickness of the tendons and bursa, among other effects.

How is shoulder bursitis diagnosed?

Along with a thorough medical history and physical examination, diagnostic testing for bursitis may include the following:

  • X-ray: The diagnostic test that makes images of inside tissues, bones, and organs on film using invisible electromagnetic energy beams.
  • Magnetic resonance imaging: A diagnostic imaging procedure that makes detailed images of organs and structures within the body by combining huge magnets, radiofrequency energy, and a computer.
  • Ultrasound: A diagnostic imaging procedure that examines the inside organs and tissues using high-frequency sound waves.
  • Aspiration: A treatment that includes withdrawing fluid from a swollen bursa with a tiny needle to check the infection or gout as a possible cause of bursitis.
  • Blood tests: Laboratory testing may be performed to confirm the other possible conditions.

How is shoulder bursitis treated?

Treatment without Surgery:

The first step in treating shoulder bursitis is to reduce inflammation. Avoid painful activities such as reaching or extending beyond your comfort zone. Anti-inflammatory drugs such as Motrin or Advil can also be used to treat inflammation. These medications aid in the reduction of swelling and pain.

Many patients experience to benefit from a few weeks of these methods to treat shoulder bursitis. Simple exercises or physiotherapy may help you return to regular, (Bursitis of the Shoulder | Cedars-Sinai, 2019) pain-free activities as the discomfort is gone.

If the symptoms do not improve, a cortisone injection, or steroid shot, into the swollen region is generally the next step. Cortisone is a potent anti-inflammatory medication that is used to treat swelling rather than pain. If your early symptoms are severe, your doctor may inject you with cortisone on your initial appointment. The most serious disadvantage is that cortisone injections may deteriorate tendons. Cortisone injections repeated should be undertaken cautiously, (Bursitis of the Shoulder | Cedars-Sinai, 2019).

Surgical Treatment:

Occasionally, surgery is required to treat shoulder bursitis. This can be accomplished by a tiny incision and the use of a specialized, minimally invasive probe known as an arthroscope. The inflammatory bursa, some bone, and any spurs are removed during surgery to allow more space for the rotator cuff tendons, (Bursitis of the Shoulder | Cedars-Sinai, 2019).

What Can a Physical Therapist Do to Help?

Your physical therapist will collaborate with you to develop a personalized treatment plan that can accelerate your recovery, which will include exercises and treatments that you may perform at home. Physical therapy will assist you in resuming your usual activities and lifestyle. The time required to heal the issue varies, but when a thorough stretching and strengthening exercise is adopted, benefits are frequently attained in two to eight weeks, (Physical Therapy Guide to Shoulder Bursitis, 2015).

Your physical therapist may suggest you do the following over the first 24 to 48 hours following your diagnosis:

  • Rest the shoulder by avoiding activities that cause pain, such as lifting or reaching overhead.
  • Every two hours, apply ice packs to the shoulder for 15 to 20 minutes.
  • Consult a physician if further treatments, such as medicine or diagnostic testing, are required.

Your physiotherapist will assist you in the following ways:

  1. Reduce Inflammation and Pain: If repetitive activities created bursitis in the shoulder, your physical therapist can assist you to learn how to avoid or alter those activities to allow healing to begin. To regulate and relieve your pain and swelling, your physical therapist may use a variety of treatments and technologies, including cold, heat, ultrasonography, electrical stimulation, (Physical Therapy Guide to Shoulder Bursitis, 2015), taping, particular exercises, and hands-on therapy, such as specialist massage.
  2. Accelerate Motion: Your physical therapist will select particular activities and treatments to aid in the restoration of normal shoulder and arm flexibility. These may begin with “passive” motions performed by the physical therapist to gently move your shoulder joint and advance to self-performed active exercises and stretches.
  3. Increase your flexibility: Your physical therapist will examine whether any shoulder, chest, or arm, neck muscles are stiff and will assist you in stretching them as well as educate you on how to stretch them.
  4. Improved posture: If it is determined that your posture difficulties are connected to your disease, your physical therapist will work with you to help you modify your posture in order to relieve your discomfort and avoid future recurrences.
  5. Strengthen: Bursitis of the shoulder is frequently associated with weak, or uncoordinated shoulder muscles. At each stage of treatment, certain exercises and equipment will assist in healing; your physical therapist will choose and teach you the proper exercises and equipment to utilize to gradually regain your strength and agility. Among these include the use of cuff weights, stretching bands, and (Physical Therapy Guide to Shoulder Bursitis, 2015) weight lifting equipment.
  6. Boost Endurance: Rebuilding muscle endurance in the shoulder is critical following an injury. Your physical therapist will give you routines to increase your muscle endurance and allow you to resume daily activities. Cardiovascular exercise equipment such as upper-body ergometers, treadmills, or stationary bicycles may be employed.
  7. Acquire knowledge about a home treatment: Your physical therapist will demonstrate at-home strengthening and stretching activities. These exercises will be personalized to your unique needs; if performed according to your physical therapist’s instructions, you can expedite your recuperation, (Physical Therapy Guide to Shoulder Bursitis, 2015).
  8. Return to the Activities:  Your physical therapist will review your activity objectives with you and utilize them to establish recovery objectives for work, sport, and home. Your treatment plan will assist you in achieving your objectives in the safest, quickest, and most effective manner possible. To assist you in achieving your goals, your physical therapist will teach you exercises, work retraining activities, and sport-specific methods and drills.
  9. Accelerate Recovery Time: Your physical therapist is qualified and skilled in selecting the most effective treatments and exercises to assist you in safely healing, resuming your regular lifestyle, and achieving your objectives faster than you would on your own, (Physical Therapy Guide to Shoulder Bursitis, 2015).

References:

Bursitis of the Shoulder | Cedars-Sinai. (2019). Cedars-Sinai.org. https://www.cedars-sinai.org

Bursitis Shoulder Pain: Symptoms, Treatment, and Exercises. (2017, June 1). Healthline. https://www.healthline.com/

Physical Therapy Guide to Shoulder Bursitis. (2015, May 26). American Physical Therapy Association. https://www.choosept.com/

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