Shoulder bursitis is a condition of the shoulder joint. The rotator cuff is a group of four muscles and their tendons that wrap around to form a “cuff” over the upper end of the arm at the shoulder. The rotator cuff helps guide the shoulder through many motions by allowing lift and rotation to the arm while stabilizing the ball of the shoulder within the socket. The space over the top of the rotator cuff is occupied by a bursa which is a fluid sac between the tendon and the acromion bone.
Bursitis, a common condition, is inflammation of this fluid sac and occurs with repetitive overhead activity or overuse of the arm. The term impingement refers to pinching of the rotator cuff tendons and bursa against the acromion bone above it.
Cause & Symptoms
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Your arm is kept in your shoulder socket by your rotator cuff. These muscles and tendons form a covering around the head of your upper arm bone and attach it to your shoulder blade.
There is a lubricating sac called a bursa between the rotator cuff and the bone on top of your shoulder (acromion). The bursa allows the rotator cuff tendons to glide freely when you move your arm.
The rotator cuff is a common source of pain in the shoulder. Pain can be the result of Bursitis. The bursa can become inflamed and swell with more fluid causing pain.
Rotator cuff pain commonly causes local swelling and tenderness in the front of the shoulder. You may have pain and stiffness when you lift your arm. There may also be pain when the arm is lowered from an elevated position.
Beginning symptoms may be mild. Patients frequently do not seek treatment at an early stage. These symptoms may include:
Minor pain that is present both with activity and at rest
Pain radiating from the front of the shoulder to the side of the arm
Sudden pain with lifting and reaching movements
Athletes in overhead sports may have pain when throwing or serving a tennis ball
As the problem progresses, the symptoms increase:
Pain at night
Loss of strength and motion
Difficulty doing activities that place the arm behind the back, such as buttoning or zippering
If the pain comes on suddenly, the shoulder may be severely tender.
All movement may be limited and painful.
Medical History and Physical Examination
Your Great Lakes Orthopedics & Sports Medicine orthopedic surgeon will test your range of motion by having you move your arm in different directions.
After discussing your symptoms and medical history, your doctor will examine your shoulder. He or she will check to see whether it is tender in any area or whether there is a deformity.
To measure the range of motion of your shoulder, your doctor will have you move your arm in several different directions. He or she will also test your arm strength.
Your doctor will check for other problems with your shoulder joint. He or she may also examine your neck to make sure that the pain is not coming from a “pinched nerve,” and to rule out other conditions, such as arthritis.
Other tests which may help your doctor confirm your diagnosis include:
X-rays. Becauses x-rays do not show the soft tissues of your shoulder like the rotator cuff, plain x-rays of a shoulder with rotator cuff pain are usually normal or may show a small bone spur. A special x-ray view, called an “outlet view,” sometimes will show a small bone spur on the front edge of the acromion.
Magnetic Resonance Imaging (MRI) and Ultrasound. These studies can create better images of soft tissues like the rotator cuff tendons. They can show fluid or inflammation in the bursa and rotator cuff. In some cases, partial tearing of the rotator cuff will be seen.
Great Lakes Physical Therapy
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