What Is Subacromial Bursitis?

Subacromial bursitis is an intense pain in your shoulder that gets worse when you move. Getting treatment early can help prevent long-term joint problems.

What Is It?

All over your body there are small sacs filled with fluid called bursae (that’s plural for bursa). These are thin cushions between your bones and the moving parts of your body like muscles and tendons. If a bursa gets swollen and fills up with more fluid than it should, you have a condition called bursitis. This happens most often in bursae near joints like your hips, elbows, and knees that repeat the same motions over and over again.

Your shoulder is another common place for bursitis. The subacromial bursa in each shoulder helps a group of muscles and tendons known as the rotator cuff to function. If it gets swollen, you have subacromial bursitis.

What Causes It?

Sometimes, an injury damages the bursa in your shoulder. Overuse of your shoulder muscle can also cause damage. People who do a lot of overhead lifting and forceful pulling on the job are at risk.

Being very active can also harm your bursa, especially if the sport you play involves throwing or pitching.

Other factors that can help cause this type of bursitis:

Your age. Bursitis in your shoulder becomes more likely the older you get.

Poor posture. Sit up straight, don’t slump.

Poor flexibility. Stretch before you work out.

The shape of your shoulder bone can be a factor too. You may have less space between your tendon and bursa than most people. An infection, arthritis, gout, diabetes, or thyroid disease can also play a role.

What Are the Symptoms?

If you have subacromial bursitis, you may notice shoulder stiffness and pain. It may hurt badly enough to wake you up at night. There might also be swelling and redness. Your shoulder may be sore to the touch, especially on the front side or the upper third of your arm.

If your bursitis is advanced, you may not be able to move your shoulder much at all. It may lead to a condiition called a “frozen shoulder.”

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How Is It Diagnosed?

Your doctor will ask about your symptoms. She’ll check to see if your shoulder’s warm to the touch or tender. She’ll also gently move your arm in different directions to check your range of motion.

An imaging test may be done too. An X-ray can give a clear view of your bones and rule out common ailments like arthritis that share some of the same symptoms. An MRI (magnetic resonance imaging) can show if your bursa is filled with fluid.

If your doctor suspects that an infection is causing your bursitis, she may order a blood test. In some cases, fluid from the bursa can be drained and tested.

What’s the Treatment?

Rest. You’ll need to take a break from all activities or movements that cause you pain.

Over-the-counter pain relief. Medicines like ibuprofen, naproxen, or aspirin can ease swelling and soreness.

Ice. A cold pack on your shoulder will reduce swelling. Aim for 10-15 minutes once or twice a day.

Medicine. If your pain is intense, your doctor may inject a steroid into the area around your shoulder bursa. This will help manage your pain. If an infection turns out to be the cause of your bursitis, you may need antibiotics.

Stretch and strengthen your shoulder. Once your pain goes away, your doctor might give you exercises to do to help your shoulder return to its normal range of motion. She may also suggest physical therapy.

Will I Need Surgery?

Most of the time, subacromial bursitis improves after a few weeks of home care. If your shoulder doesn’t get any better, then surgery could be an option.

Your inflamed bursa could be taken out so a new, healthy one can grow in its place. Sometimes, bone is removed to make more room for your rotator cuff tendon. If your doctor thinks you need surgery, talk to him about which procedure will best help your shoulder.

WebMD Medical Reference Reviewed by Tyler Wheeler, MD on May 17, 2019

Sources

SOURCES:

National Institute of Arthritis and Musculoskeletal and Skin Diseases: “Questions and Answers about Bursitis and Tendinitis,” “Questions and Answers about Shoulder Problems.”

American College of Rheumatology: “Tendinitis (Bursitis).”

Mayo Clinic: “Bursitis.”

Cedars-Sinai: “Bursitis of the Shoulder.”

Scottsdale Liberty Hospital: “Surgical Treatment of Shoulder Bursitis.”

UNC School of Medicine/Family Medicine Center: “Subacromial Bursitis -- Patient Care.”
Case Reports in Orthopedics: “Spontaneous Isolated Infection of the Subacromial Bursa.”

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