Shoulder Bursitis
Shoulder Bursitis
Bursitis in the shoulder — sometimes written as bursitis shoulder or bursitis on the shoulder — is one of the most common causes of shoulder pain we see. If you’re asking what is bursitis of the shoulder, it’s inflammation of the small fluid-filled sac (the bursa) that cushions the tendons as they move over the shoulder bone. The most commonly affected bursa is the subacromial bursa, sometimes referred to as the sub bursa. It is located between the top of the shoulder (acromion) and the rotator cuff tendons. The subacromial bursa helps reduce friction between the tendons of the rotator cuff and the acromion, which is part of the shoulder blade. When this bursa becomes inflamed, it can cause pain and difficulty moving the shoulder.
Specifically, this is often SASD bursitis — short for subacromial-subdeltoid bursitis, referring to the two connected bursae most commonly affected in the shoulder.
Symptoms of Shoulder Bursitis
- Pain in the front of the shoulder: This is the most common symptom, often worsening with overhead activities or lifting.
- Tenderness: The area around the biceps tendon may be tender to touch.
- Weakness: Difficulty lifting or carrying objects, especially with the arm extended.
- Stiffness: Reduced range of motion in the shoulder.
- Clicking or popping sensation: Sometimes felt in the shoulder during movement.
Treatment We Offer
Ultrasound-guided cortisone injections provide precise treatment for Shoulder Bursitis by delivering anti-inflammatory medication directly to the affected area.
Mechanism of Action of Cortisone for Shoulder Bursitis
- Anti-inflammatory Effect:
Cortisone works by mimicking the effects of cortisol, a hormone naturally produced by the adrenal glands. It has a potent anti-inflammatory effect that helps suppress the inflammatory response in the bursa.
When injected directly into the affected area (such as the subacromial bursa in the shoulder), cortisone reduces the production of inflammatory mediators like prostaglandins, leukotrienes, and cytokines. These are the chemicals responsible for initiating and maintaining the inflammatory process.
This inhibition leads to a reduction in the swelling, redness, and heat around the inflamed bursa, which decreases the overall inflammation and associated pain.
- Vasoconstriction:
Cortisone promotes vasoconstriction (narrowing of blood vessels), which decreases the amount of blood flow to the inflamed area. This reduces the amount of fluid that accumulates in the bursa, thus alleviating swelling and pressure on surrounding tissues.
- Pain Relief:
By reducing inflammation and swelling, cortisone helps to relieve pressure on the nerves and tissues around the shoulder, providing significant pain relief.
Additionally, cortisone decreases the release of substances like bradykinin that are involved in pain signaling, leading to reduced pain perception in the affected area.
- Immune System Suppression:
Cortisone suppresses the activation of the immune system, particularly the white blood cells involved in inflammatory processes. This helps prevent the immune system from exacerbating inflammation in the burs
Your Care Pathway with us
- To book an appointment you can call our reception line, 0142084487, or email to info@altonpainclinic.co.uk or click the button given below.
- Comprehensive Musculoskeletal examination and testing.
- Same day Ultrasound Guided Injection for pain relief.
- Discussion of your treatment plan, treatment plan can include advanced treatments for example Cortisone Injections, Hyaluronic injections and various other options tailored to your specific needs.
Understanding Shoulder Bursitis
Shoulder bursitis is the inflammation of one or more of the bursa sacs in the shoulder. Bursae are small, fluid-filled sacs that act as cushions between bones, tendons, muscles, and skin. They help reduce friction and allow smooth movement of joints. When a bursa becomes irritated or inflamed, it leads to bursitis.
In the shoulder, the most commonly affected bursa is the subacromial bursa, located between the top of the shoulder (acromion) and the rotator cuff tendons. The subacromial bursa helps reduce friction between the tendons of the rotator cuff and the acromion, which is part of the shoulder blade. When this bursa becomes inflamed, it causes pain and difficulty moving the shoulder.
Causes of Shoulder Bursitis
Several factors can lead to shoulder bursitis:
- Repetitive Motion: Frequent overhead movements, such as throwing, lifting, or swimming, can irritate the bursa over time, leading to inflammation.
- Trauma or Injury: A direct blow to the shoulder or an acute injury can cause irritation and inflammation of the bursa.
- Aging: As we age, tendons and bursae lose some of their elasticity, making them more prone to irritation and injury.
- Poor Posture or Body Mechanics: Poor posture or improper techniques during physical activity or work can put strain on the shoulder, leading to bursitis.
- Underlying Conditions: Certain conditions, such as rheumatoid arthritis, gout, or diabetes, can increase the risk of bursitis by affecting the body’s inflammatory response.
Types of Shoulder Bursitis
- Subacromial Bursitis: The most common form of shoulder bursitis, affecting the bursa between the acromion (the bony part of the shoulder) and the rotator cuff.
- Subdeltoid Bursitis: A less common form of bursitis that involves the bursa underneath the deltoid muscle (the muscle that gives the shoulder its round shape).
Diagnosis
Diagnosis often includes a specific test for bursitis of the shoulder — your clinician will move your arm through certain positions to reproduce the pain — alongside ultrasound to confirm the diagnosis.
Most cases respond well to ultrasound-guided cortisone injection; is rarely needed and only considered when conservative treatment, including injection, hasn’t resolved persistent symptoms.
Choosing Alton Pain Clinic for Shoulder Bursitis
At Alton Pain Clinic, we take a personalised approach to treating shoulder bursitis, using clinical assessment and ultrasound guidance where appropriate. Our aim is to identify the source of your shoulder pain and provide a suitable treatment plan based on your individual needs. If shoulder bursitis is affecting your movement or everyday activities, our team can assess your symptoms and discuss appropriate treatment options, including ultrasound-guided injections where clinically indicated.
Frequently Asked Questions
What does SASD bursitis mean?
SASD stands for subacromial-subdeltoid — the two connected bursae in the shoulder most commonly affected by bursitis.
Is surgery ever needed for shoulder bursitis?
Rarely. Most cases improve with ultrasound-guided cortisone injection and activity modification. Surgery is only considered when these haven’t resolved persistent symptoms.
Can shoulder bursitis go away on its own?
Mild cases may improve with rest, activity modification and appropriate conservative treatment. However, persistent or worsening shoulder pain should be assessed by a clinician.
Can a cortisone injection help shoulder bursitis?
A cortisone injection may help reduce inflammation and provide pain relief in some people with shoulder bursitis. Your clinician will assess whether an injection is appropriate for you.