Most clinical words ending in “itis” means inflammation of some sort – for example, peritonitis and laryngitis. A bursa is a fluid-filled sac which prevents muscle insertions rubbing on bones within your body.
Shoulder bursitis occurs when one of the bursa sacs around your shoulder joint becomes inflamed and sore. Often the cause of this is overuse – constant, repetitive movements of the arm rub the tendon permanently on the shoulder bursa, which then causes the inflammation. After that, any lifting of the arm above 90 degrees or overhead causes pain and interferes with mobility. At best, shoulder bursitis is a nuisance, at worst can spell problems for the continuing career of an athlete. If your livelihood depends on you fast-bowling in cricket, then the onset of bursitis can be a disaster.
There are two bursae in the shoulder that are most likely to be affected:-
This little sac lies on the side of your upper arm, where your main shoulder muscle (deltoid) meets your arm bone (humerus). If you have pain when your arm is held out to the side at shoulder height, and you are sure that you have not sustained a rotator cuff injury, then bursitis is likely to be the cause. If the pain seems to be at the top of the shoulder as opposed to partway down the arm, it may be caused by impingement. Shoulder impingement occurs when the soft tissues of the shoulder become trapped under the bony bit on the top of the shoulder girdle (called the acromium process), causing – surprise, surprise – painful inflammation.
This bursa sits on top of the shoulder; if moving your arm in an arc from 90* to reach your fingers to the ceiling causes the pain, this is possibly the culprit. Bursitis in this area is also known as shoulder impingement.
If you can tick the above boxes regarding pain in the shoulder, and especially if you have been performing lots of repetitive-type movements, then you probably have shoulder bursitis. A visit to a physician for diagnosis is a good idea, although there are some elements of shoulder therapy that you can do yourself:-
- Rest from the activity you are doing. Bursitis is an overuse injury, and many cases will clear up all by themselves if left in peace and not aggravated.
- Ice the area. Take the appropriate ice precautions. Cold reduces inflammation and can speed up recovery. In acute stages do not be tempted to hop into a hot bath to ease the pain – it may feel better at the time, but in the long run will make things worse.
- In severe and chronic cases, an injection of hydrocortisone may be necessary.
- When inflammation has eased, build up your surrounding shoulder muscles to take some of the strain.
Most cases of bursitis respond well to conservative treatment, and may not recur if the appropriate remedial and rehabilitation exercises are done regularly.