Subacromial Bursitis

Author: Courney Erickson-Adams, MD

Shoulder pain affects may people, especially as they get older. Repetitive overhead motion and the changes of aging can create wear and tear on the shoulder joint that may cause inflammation and pain.  When this happens, it can impact proper functioning of the joint and arm. Subacromial bursitis is one culprit that causes shoulder pain and can lead to reduced function. Here, we’ll describe the specifics of this condition—including definitions, symptoms, causes, and options for treatment.

What is subacromial bursitis?

Bursitis is a condition in which bursa—which are small, fluid-filled sacs that act as cushions between bone and other tissues—become swollen and fill up with more fluid than normal. The acromion is the tip of the shoulder blade. Therefore, subacromial bursitis occurs when there is inflammation in the bursa and tendons below the acromion and above the top of the arm bone (humerus) within the shoulder joint. 

Subacromial bursitis is also referred to as rotator cuff impingement syndrome when bursitis is accompanied by inflammation in the tendons of the rotator cuff. The rotator cuff is made up of the four tendons that stabilize the shoulder joint and connect to the four muscles that allow the shoulder to move in various directions. 

Normally, tendons slide easily within the subacromial space, but when inflammation is present in bursa and tendons, there isn’t enough room for normal function, and impingement—or pinching—occurs.

What are common symptoms of subacromial bursitis?

Common symptoms of subacromial bursitis include:

  • Pain with activities that require reaching overhead
  • Pain on the outside of the upper arm and shoulder
  • Pain while lying on the shoulder, which is usually at night
  • Swelling and redness at the site 

What causes subacromial bursitis?

Risk factors for this condition include:

  • Repetitive overhead activity of the shoulder
  • Injury to the shoulder
  • Bone and joint abnormalities
  • Age-related changes to the shoulder joint

How is subacromial bursitis diagnosed?

Diagnosing subacromial bursitis starts with a physical examination, which should be conducted by a healthcare provider who has specific expertise in this area. The provider will then determine if additional imaging tests are needed. These may include x-rays and possibly an MRI (Magnetic Resonance Imaging) to obtain a more detailed evaluation. 

How is subacromial bursitis treated?  

Treating subacromial bursitis usually begins with a conservative approach. This may include:

  • Rest
  • Physical therapy
  • Anti-inflammatory medications (check with your doctor before taking any medications)
  • Cortisone injections

If a conservative approach doesn’t prove effective, surgery may be an additional option. 

If you are experiencing shoulder pain of any kind, our team of experts is uniquely equipped to provide the evaluation and treatment you need.  Contact us today.