Shoulder Bursitis : Symptoms, Causes & Treatment

What is Shoulder Bursitis?

Bursae are small, fluid-filled sacs that are located in joints throughout the body. The cushion between the bones and overlying soft tissues.

Bursitis of the shoulder (impingement syndrome) occurs when there is swelling and redness between the top of the arm bone and the tip of the shoulder. Between these bones lie the tendons of the rotator cuff and a fluid-filled sac called the bursa, which protects the tendons. The symptoms of shoulder bursitis are dull ache, sharp pain, or mild tenderness. Other signs include Shoulder stiffness or a feeling of swelling and painful range of motion [1].

Symptoms of Shoulder Bursitis

The symptoms of shoulder bursitis are pain in doing overhead movement and in lifting heavier objects. Other symptoms are tenderness in the front of the shoulder, pain in lying on the affected side, stiffness in the arm and shoulder, and feeling weakness in lifting objects [1].

Causes and Risks of Shoulder Bursitis

  • The most common factor of having shoulder bursitis is repetitive head movement activities like basketball, swimming, and tennis.
  • The other cause of shoulder bursitis is lifting heavy objects especially overhead lifting which can cause bursitis.
  • Moreover, the injury or direct blow or fall towards the shoulder can cause inflammation.
  • One who has diabetes, rheumatoid arthritis, gout, thyroid disease have a risk factor of having bursitis in the shoulders
  • It is also seen that improper posture during sleeping or other activities can cause bursitis.
  • Some studies have also proved that again factor can also be the reason for having bursitis [2].

Normal Healing cycle

The normal healing cycle consists of three stages. Inflammation, proliferation, and maturation.

  1. The inflammation stage consists of pain, swelling, temperature, and redness. It plays an important role in healing ad swelling helps to protect the nearby tissues from damage. Increased temperature causes the disposal of pathogens and it alerts the white blood cells to start the healing cycle.
  2. In the proliferation stage, scar tissue formation occurs at the affected area so that the healing process continues by fascia restrictions and muscle spasms. The Healing cycle cannot get started without the formation of scar tissues.
  3. The last stage is maturation in which the healing cycle is completed by the formation of the new skin cells which replace the scar tissues [3].

Healing Cycle of Shoulder Bursitis

The healing cycle of shoulder bursitis is slightly different from the normal healing cycle because when bursitis of the shoulder is caused by a physical injury, it can be treated within a few days. Recovery time is longer if bursitis is caused by overuse. It may take several weeks or more to heal, especially if the shoulder joint is still being used [4].

Not Effective Treatment for Shoulder Bursitis

Most of the normal treatments are not effective for shoulder bursitis.

  1. Heat and ice therapy are effective in relieving tissues and muscles due to physical stress and fatigue but are not very effective for shoulder bursitis.
  2. Electronic stimulation (Estim) therapy is effective in recovery after tendon injuries but they are not very effective in shoulders bursitis.
  3. Foam rollers refer to the Self- myofascial Release Technique (SMR) which releases tightness and sourness in the tissues and muscles but this therapy is not effective enough for shoulder bursitis.
  4. Massage and stretching are not very effective in shoulder bursitis because it can’t be done deep in the affected area but it is effective when muscles and tissues are effective due to increased muscular activity and stretching results in further compression at the irritating point which further make the pain worst.
  5. Joint mobilization is the careful use of skilled graded forces to move a joint in the desired direction but it is not much effective in shoulder bursitis because if it is done in the inflammatory stage it will cause more inflammation.
  6. Strength exercises especially during the inflammation stage are not effective for shoulder bursitis because if we do repetitive motions with the affected area, the condition will get worse [5].

Effective Treatment for Shoulder Bursitis

 Inflammation stage:

In the inflammatory stage, rest is good enough because repetitive motions at the affected area can worsen the pain, especially overhead lifting. MagnaHeal is a more effective treatment for shoulder bursitis. It is a strong magnet that is wrapped around the shoulder and they attract and align the acromion the soft tissues and make space between them. It is also said that an anti-inflammatory diet can also be a good approach as others because the diet taken which is anti-inflammatory will decrease and prevent swelling, redness, and inflammation. If there is a vitamin, minerals deficiency it can stop the healing cycle so these vitamins should be restored so that the healing cycle continues [6].

Proliferation stage:

The proliferation stage is treated by scar tissue release, trigger point release, and fascia release. Scar tissue release is done by A3 which is used to break superficial scar tissues and trigger point release is done by A5 which is used to break deep superficial scar tissues. They are designed to break the adhesions by applying pressure and realigning the soft tissues [6].

Fascia release is done on fascia layers. They are composed of superficial and deep(aponeurotic, epimysium, perimysium, and endomysium)layers. A1 is used to release the superficial and aponeurotic fascia and A5 releases endomysium, epimysium, and perimysium. To reduce the pain all the layers should be released [6].

Conclusion

Shoulder bursitis is a chronic and painful disease that is caused between the top of the arm and the tip of the shoulder. It can be treated by physiotherapists and professional therapists who treat shoulder bursitis by different therapies i.e A1, A3, A5, and MagnaHeal.

References 

  1. VanBaak K, Aerni G. Shoulder conditions: rotator cuff injuries and bursitis. FP essentials. 2020 Apr;491:11-6.
  2. Aaron DL, Patel A, Kayiaros S, Calfee R. Four common types of bursitis: diagnosis and management. JAAOS-Journal of the American Academy of Orthopaedic Surgeons. 2011 Jun 1;19(6):359-67.
  3. Pogorzelski J, Imhoff AB, Degenhardt H, Siebenlist S. Primäre (idiopathische) Schultersteife. Der Unfallchirurg. 2019 Dec;122(12):917-24.
  4. Strakowski JA, Visco CJ. Diagnostic and therapeutic musculoskeletal ultrasound applications of the shoulder. Muscle & nerve. 2019 Jul;60(1):1-6.
  5. Brantingham JW, Cassa TK, Bonnefin D, Jensen M, Globe G, Hicks M, Korporaal C. Manipulative therapy for shoulder pain and disorders: expansion of a systematic review. Journal of manipulative and physiological therapeutics. 2011 Jun 1;34(5):314-46.
  6. Hanchard NC, Goodchild L, Thompson J, O’brien T, Davison D, Richardson C. Evidence-based clinical guidelines for the diagnosis, assessment and physiotherapy management of contracted (frozen) shoulder: quick reference summary. Physiotherapy. 2012 Jun 1;98(2):117-20.