Subacromial Bursitis

A bursa is a thin sac toward the top of the shoulder that sits atop the rotator cuff. This thin sac provides a lubrication that allows the tendons to smoothly glide under the bone above them when the arm is raised. Sometimes this bursa can become inflamed, causing shoulder pain with simple movements.

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Subacromial bursitis, or inflammation of the bursa below the acromion, may be caused by a bone spur on the undersurface of the bone. This bone spur can pinch the bursa and underlying rotator cuff when the arm is raised out to the side. There are several great treatment options available that can help alleviate the inflammation in the bursa and restore function. When patients fail more conservative treatments, such as physical therapy, anti-inflammatory pain medication, and steroid injections into the bursa, they may be a candidate for a shoulder arthroscopy, removal of the acromial bone spur, and bursectomy, which is removal of the inflamed bursal tissue.

  • Symptoms

  • Treatment

Symptoms

  • Persistent shoulder pain when reaching out to the side, behind the back, or across the body
  • Limited range of motion
  • Pain is usually minimal at rest
  • Weakness due to pain

Frequently Asked

Questions

How do I know if I have subacromial bursitis?

Subacromial bursitis can be diagnosed clinically with a detailed history and a thorough physical exam. If patients demonstrate weakness, an MRI will be ordered to ensure no other soft tissue structures have been injured. An MRI evaluates soft tissue structures such as the rotator cuff tendons and subacromial bursa.

How do I know if I need surgery or can just manage with conservative treatment?

Typically, subacromial bursitis is managed conservatively for a few months. Most patients improve without needing surgery. If patients continue to have pain and limitations despite physical therapy, steroid injection, and anti-inflammatories, surgery is recommended.

What are the risks associated with not treating my subacromial bursitis?

The most common risks are stiffness, persistent pain, and weakness. Patients with subacromial bursitis commonly use their injured arm less, which can lead to weakness in the shoulder as well as increased tension in the muscles around the shoulder that compensate for the decreased shoulder movement.