The shoulder joints are versatile when it comes to a range of motions and play a big role in almost all activities involving the upper body. But their adaptability, coupled with the ball-and-socket mechanics, make them prone to injuries and wear and tear.
Of the many injuries and conditions that affect the joints, shoulder bursitis, caused by overuse or certain diseases, is often misdiagnosed and ignored. Bursitis is the inflammation of the bursa, a sac-like structure found between bones, muscles, tendons and ligaments in the shoulders.
“The bursa is a fluid-filled sac which is usually present in the area that encounters friction,” says Dr Sushanth Mummigatti, consultant, orthopedics, Manipal Hospitals, Panjim, Goa. “The joints experience friction, so nature has provided a cushion — bursa, which is a natural protective mechanism. When the bursa becomes inflamed or swollen, it is called bursitis. It can happen in any of the joints and one of the clinically important places is the shoulder joint.”
If ignored, shoulder bursitis — also known as glenohumeral bursitis — not just makes doing day-to-day tasks difficult but can also lead to infection and onset of arthritis.
Causes of shoulder bursitis
Overuse of the shoulder joint for overhead abduction is the most common reason for shoulder bursitis. Overhead abduction is required while performing various upper-body actions in sports or day-to-day activities that involve overhead movement or lifting.
Trauma or injury to the shoulders is another major reason. Hyper-cholesterol, which leads to deposition of cholesterol in the shoulders, diabetes, auto-immune conditions (like rheumatoid arthritis) and impingement of the shoulder can lead to bursitis.
Symptoms of shoulder bursitis
Shoulder pain is the most common symptom but bursitis pain is of a particular type.
“The pain occurs in the front and outer part of the shoulder,” says Dr Mummigatti. “And the pain increases while raising the hand. In acute cases, the pain becomes unbearable even while doing simple activities like wearing clothes. The bursa gets impinged, leading to the pain.”
Other symptoms include localized swelling, localized rise in temperature and difficulty in making shoulder movements like opening a door.
Shoulder bursitis treatment
Shoulder bursitis is classified into three types: acute, chronic and recurrent bursitis.
“For acute shoulder bursitis, rest is the main treatment,” says Dr Mummigatti. “If the bursa has swelled because of certain activities, then a restriction should be put on such activities. And if required, an arm pouch should be used for immobilizing the shoulder joint along with ice pack application. Anti-inflammatory drugs can be used under medical guidance, but the most important thing is a proper clinical diagnosis.”
For chronic shoulder bursitis, further diagnosis is required to ascertain the reasons for lack of recovery or improvement. The reasons could include tendonitis in the supraspinatus muscles of the shoulder. For elderly people, calcium crystal deposition in the shoulder joint could lead to bursitis pain.
“Recurrent bursitis requires a proper investigation for ascertaining the reason for it,” adds Dr Mummigatti. “Some people may have changes in the acromion, which makes it more prone to bursitis.”
Treatment measures for recurrent bursitis include steroid injections to reduce the inflammation. In extreme cases, surgeries are performed to remove the inflamed part of the bursa.
Shoulder bursitis prevention
Overuse is the most common reason for shoulder bursitis among youngsters. To counter this, put a restriction on the kind of activity causing inflammation in the bursa.
“If the bursitis is due to the deposition of calcium crystals, then the reasons, which may include abnormal metabolism or abnormal renal function, must be checked,” says Dr Mummigatti. “The treatment is prescribed accordingly. Physiotherapy sessions are also important. [Here] the focus should be on strengthening exercises for the shoulder and scapula stabilizing exercises.”
Takeaways
- Shoulder bursitis is the inflammation of the bursa, a sac-like structure which is a natural protective layer present in the joints.
- Overuse of the shoulder joint is the most common cause for bursitis. As a preventive measure, restrict activities which causes an inflammation in the bursa.
- If ignored, it could lead to chronic pain and infection, and even trigger the onset of arthritis.
