Bursitis is classified as a disease of periarticular tissues. Over the past 20-30 years, the incidence of periarticular tissue diseases has increased significantly. Specialists believe that one of the reasons is the growing interest in practicing sports, including tennis and golf. What are the causes and symptoms of Bursal Bursitis? How is the treatment going?

Subacromial bursitisis the mildest form of the subacromial tightness syndrome, which occurs as a result of the narrowing of the space between the head of the humerus and the shoulder process of the scapula. This can be caused by prolonged and repeated movements of the upper limb overhead, such as when playing tennis, golfing or swimming.

Untreated bursitis may cause chronic pain as well as weakening of the blood supply to the shoulder tendons and, consequently, their rupture.

Subacromial bursitisdevelops as a result of mechanical irritation, leads to its thickening and, consequently, to the development or intensification of the so-called sub-brachial tightness - i.e. the narrowing of the space between the head of the humerus and the ligaments that make up the shoulder joint.

Subacromial bursitis is the same initial stage of the subacromial tightness syndrome, i.e. the first stage of shoulder rotator cuff disease.

Dr. Tomasz Kowalski, MD, specialist in orthopedics and traumatology of the musculoskeletal system at the Carolina Medical Center

For people suffering from pain caused by bursal bursitis, the good news is that in 90% of cases, the condition can be healed without the need for surgical interventions.

The key element of the therapy is properly selected rehabilitation. Its task is to strengthen the muscles of the shoulder girdle and stabilize the scapula, thereby moving the head of the humerus away from the shoulder process and reducing the risk of further irritation of the bursa.

In order to start exercising effectively, it is necessary to control acute pain. In addition to standard oral medications and steroid injections, biological treatments are also available. Platelet-rich plasma (PRP) is a concentrate of proteins andgrowth factors that are obtained from the patient's own blood. It is an alternative to steroid blockers as it modulates inflammation and reduces pain. The administration of PRP is also devoid of the potential side effects associated with steroid blockages.

In the event of failure of conservative treatment, the so-called arthroscopic subacial decompression. The operation is performed under general anesthesia and takes about 45 minutes. and consists in the removal of the thickened bursa and the plasticization (alignment) of the shoulder process. After the surgery, rehabilitation and gradual return to everyday activities begin immediately.

Subacial bursitis - symptoms

The first stage of the disease is associated with inflammation and swelling of the subacral bursa. Pain occurs during exercise. It also accompanies the lifting of the arms above the head. The movement of the arm is severely restricted.

Characteristically, in the first stage of inflammation, there is no pain at rest. There is also little or no muscle wasting. Some patients complain of slight weakening of the arm muscles.

Subacial bursitis - diagnosis

X-rays of the shoulder joint are taken in patients. The resulting image may show a spur on the lower surface of the brachial process which narrows the subacromial space.

If the image does not give a clear answer about the cause of the ailment, perform ultrasound or magnetic resonance imaging. These tests reveal the inflammation and rupture of the rotator cuff tendon.

For diagnostic purposes, a single injection of the corticosteroid preparation is allowed. If the medication does not improve, it is not re-injected due to the possibility of side effects and the risk of weakening of the rotator cuff and even a joint infection.

Subacial bursitis - treatment

In the initial stage of treatment, conservative treatment is applied, which consists of:

  • change or modification of physical activity
  • using appropriate physiotherapeutic treatment
  • use of oral non-steroidal anti-inflammatory drugs
  • using appropriate treatments in the field of physical therapy: cold therapy and thermotherapy. First, cold is used - removal of inflammation, local anesthesia, and then after the acute inflammation has subsided, heat is applied - never the other way around). Iontophoresis (electrotherapeutic treatment with the use of a drug) or phonophoresis (ultrasound treatment with the use of a drug), neuromuscular stimulation (e.g. TENS currents)

Improvement of the mechanical function of the shoulder joint is possible only when the proper function of the muscles of the rotator cuff is maintained.

If these methods fail, the above-mentioned injection of corticosteroids in the subacial area can be used. When conservative treatment does not bring improvement after 3-6 months, a surgical procedure should be considered that removes the mechanical cause of the tightness of the subacromial space. The procedure is performed using an arthroscope, which minimizes the risk of complications and accelerates the return to full fitness.

Subacial bursitis - how to prevent it?

We can protect ourselves against the development of the inflammation of the subacial bursa by limiting the frequency of raising the arms above the head and by performing exercises recommended by the therapist. The exercises should strengthen the muscles of the shoulder rotators (the rotator cuff).

Stamina and stretching are also important, as they help reduce the risk of overload injuries. Exercises must be performed regularly and above all correctly. Otherwise, they may cause further injuries.

About the authorAnna Jarosz A journalist who has been involved in popularizing he alth education for over 40 years. Winner of many competitions for journalists dealing with medicine and he alth. She received, among others The "Golden OTIS" Trust Award in the "Media and He alth" category, St. Kamil awarded on the occasion of the World Day of the Sick, twice the "Crystal Pen" in the national competition for journalists promoting he alth, and many awards and distinctions in competitions for the "Medical Journalist of the Year" organized by the Polish Association of Journalists for He alth.

Category:

Anatomy