A COMMON SHOULDER AILMENT - Subacromial Bursitis

Bursae are fluid filled sacs present in joints and serve to decrease friction in joints. The sacs are lined by a membrane called the synovial membrane and encompass the synovial fluid.

Newmarket, Australia (prHWY.com) November 26, 2012 - Bursae are fluid filled sacs present in joints and serve to decrease friction in joints. The sacs are lined by a membrane called the synovial membrane and encompass the synovial fluid. The subacromial bursa lies just below the bony prominence (the acromion) on the outside of your shoulder in between the supraspinatus tendon and a ligament, the corracoacromial ligament (FIG.1). Bursitis is the name given to the condition whereby this structure becomes irritated and inflamed. In many cases, this condition is mistaken for a rotator cuff tears, although rotator cuff injuries can often occur in conjunction with bursitis.

The most common history that patients with bursitis present with is one of repetitive overuse or a sudden change in activity ( like the time you decided to get back to playing tennis after a 5 year period where your only upper body exercise was hanging out the laundry). There are a few factors apart from those mentioned above that can predispose a person to subacromial bursitis. Some of these factors include the natural anatomy of your acromion ( some people have an acromion that is more curved or hooked leaving less room for the bursae to move through), the presence of osteophtyes (more commonly known as 'bone spurs') as well as degenerative changes to the joint between your acromion and your collar bone ( the acromioclavicular joint).

The symptoms of subacromial bursitis include pain with overhead movements and when lying on the affected side. In more severe cases where the bursa is grossly inflamed, there may be a dull ache at rest. Often there is a "painful arc of movement"; this occurs when pain is felt in a particular range of movement as you elevate your arm. In the majority of cases, this range lies between 70 and 160 degrees of elevation. Beyond this point, the pain eases. This presentation occurs as a consequence as the bursa is pinched within the subacromial space as the arm is lifted. As the elevation continues, the bursa moves further inward, clearing the acromion allowing pain free movement.

Conservative treatment in the form of physiotherapy is the most commonly chosen treatment approach. Physiotherapy for subacromial bursitis involves reducing pain and inflammation while regaining full range of motion. There is little or no evidence for any benefit from the use of therapeutic ultrasound; therefore, non-steroidal anti-inflammatories and ice are more commonly used to treat these symptoms. In some cases, a corticosteroid injection and in more recent cases Botox (Botulinum Toxin B) is prescribed as part of this treatment to provide short term relief from pain and inflammation. In addition to relieving acute symptoms, you will be taught to correct postural and ergonomic factors, regain control of the shoulder blades as well as strengthen the muscles that stabilise the shoulder joint (rotator cuff muscles). When pain free movement is achieved, treatment progresses to regaining sport or work-specific skills. This involves proprioceptive training and agility training. Where conservative treatment is unsuccessful, surgery in the form of subacromial decompression may be necessary. This may involve removing the inflamed bursa as well as shaving off a portion of the acromion to allow the rotator cuff tendons to move through freely.

Subacromial bursitis is a manageable condition. At Pivotal Motion Physiotherapy, we take you through all the stages of rehabilitation with a treatment program individual to your needs. We believe the best intervention is early intervention. Incidentally... it also happens to be the most cost-effective. Visit us at www.pivotalmotion.com.au for more information.


Pivotal Motion Physiotherapy
Shop 213A, Level 1
Newmarket Reading Centre
Cnr Newmarket & Enogerra Rd, Newmarket QLD
Contact us: (07) 33525116
Q 4051

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Tag Words: podiatry services, brisbane physio, physiotherapy services, physiotherapy treatments

Categories: Health

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