Shoulder pain is a common condition of the population. Statistics indicate that 7 to 34% of people have shoulder pain at some point in their lives.
In the UK, 14% of the population has had shoulder pain. In the US, approximately 4.5 million consultations a year are performed for this cause, while 300,000 patients are operated on per year.
The medical terminology used for many of the commonly diagnosed shoulder conditions has changed over time and different ways of addressing these terms have emerged.
The shoulder joint is the most mobile joint in the human body, and therefore, it is composed of a complex mechanism that allows its optimal functioning.
With the general name of Bursitis , it was called that pain originating from the “bursa”, or synovial sac, which is an anatomical structure like a mattress that cushions the friction between the different bones that meet in the shoulder. Anatomically, several bursae are described within the shoulder.
There is another important anatomical structure that is a frequent cause of pain, called the “rotator cuff”, which is a set of 4 tendons that allow the main angles of mobility of the shoulder.
So it is not easy to identify if there is a single cause of pain or several involved.
Causes of bursitis
Currently, the causes of shoulder pain are classified , based on the location and origin of the pain:
- Subacromial bursitis, calcareous tendon bursitis , supraspinatus tendinitis , rotator cuff impingement, rotator cuff tear, partial or total.
- Frozen shoulder
- Acromio-clavicular disease
- Malignant lung tumors.
- Myocardial ischemia.
- Neck Pain.
- Diaphragmatic pain.
- Polymyalgia rheumatica.
Shoulder bursitis symptoms:
- Pain: This is the cardinal symptom of shoulder bursitis and has certain particular characteristics: it is gradual onset, can radiate from the shoulder to the arm or elbow, is generally unilateral, worsens when there is support on the shoulder or with the mobilization of the shoulder up and out. It is relieved when the arm is parallel to the body, supported on the back and worsens with any manual activity.
- It can be accompanied by local heat on the shoulder.
- Weakness in the affected arm.
Risk factors for shoulder bursitis:
- Age: after 40 years the risk of bursitis increases .
- Occupation or professional activity: repeated movements, or frequent weights that negatively impact the shoulder joint, have a lot to do with it. Persistent vibrations over the shoulder is another factor.
- Rheumatoid arthritis, Gout, Diabetes.
- Sports: tennis, golf, baseball.
Prevention of shoulder bursitis
- Good posture at work or predominant activity.
- Putting heavy objects on wheels and pushing heavy loads (avoid lifting too much weight).
- Take moments of rest in the activity to relax the shoulder.
- Maintain a good body weight.
- Exercise: exercise regularly, and don’t forget:
Conservative treatments for shoulder bursitis :
- Local ice, for periods no longer than 30 min every 2 to 4 hours during an initial phase of 48 hours after the pain started. Sometimes this measure is enough to calm the pain if the cause of it can be avoided or controlled.
- In the first 48 hours, only take paracetamol or acetaminophen as a pain reliever.
- Non-steroidal anti-inflammatory drugs (NSAIDs): it is recommended to start them after 48 to 72 hours. Ibuprofen, ketoprofen, or diclofenac can be used, keeping an eye on gastrointestinal and kidney side effects.
- Local arnica may be helpful for some patients.
- Physiotherapy: under the supervision of a professional, who indicates the appropriate exercises in these cases.
- Lifestyle changes.
- Labor precautions.
- Sports precautions.
Invasive Treatments for Shoulder Bursitis
- Intra-articular treatment: it is done with injections of steroids or anesthetics in the joint, which must be done by a specialist.
- Platelet-rich plasma injection.
- Surgeries: there are many types of surgery according to the exact damage of the joint, the most frequent are subacromial decompression and rotator cuff repair.
- Open surgery