Shoulder Impingement or Bursitis

A common cause of shoulder pain made worse by lifting, reaching, or repetitive overhead activity

Shoulder impingement and bursitis are common conditions that can cause pain and limit your ability to move your arm freely. Shoulder impingement occurs when the tendons of your rotator cuff become pinched or compressed between the bones in your shoulder. Bursitis happens when the bursa, a fluid-filled sac that cushions your shoulder joint, becomes inflamed. These conditions often occur together and can make everyday activities like reaching, lifting, or even sleeping uncomfortable. Early diagnosis and treatment can help relieve pain and restore your shoulder’s mobility.

CAUSES OF SHOULDER IMPINGEMENT AND BURSITIS

Shoulder impingement and bursitis are usually caused by overuse or repetitive movements of the shoulder.

Common causes include:

  • Repetitive Overhead Activities: Movements such as throwing, swimming, or lifting your arm above shoulder height can irritate the tendons and bursa.
  • Rotator Cuff Injuries: Damage or weakness in the rotator cuff muscles can cause the tendons to rub against the bones, leading to impingement.
  • Bone Spurs: Extra bone growths (spurs) on the shoulder blade can narrow the space available for tendons, leading to impingement and inflammation.
  • Aging and Wear-and-Tear: As you age, the tendons in your shoulder can weaken, making you more prone to impingement and bursitis.

SYMPTOMS OF SHOULDER IMPINGEMENT AND BURSITIS

If you have shoulder impingement or bursitis, you may experience:

  • Pain: A sharp or aching pain in the front or side of your shoulder, particularly when lifting your arm or reaching overhead.
  • Weakness: Reduced strength in your shoulder or arm, making it difficult to perform everyday tasks.
  • Stiffness: Difficulty moving your shoulder, particularly after periods of rest.
  • Swelling and Tenderness: Your shoulder may feel tender or swollen, especially if bursitis is present.
  • Pain at Night: The discomfort may worsen when lying on the affected shoulder, disrupting your sleep.

HOW SHOULDER IMPINGEMENT AND BURSITIS ARE DIAGNOSED

To diagnose shoulder impingement and bursitis, Dr Liddell will will typically perform the following:

  • Physical Examination: Dr Liddell will assess your shoulder’s range of motion, strength, and tenderness to pinpoint the source of your pain.
  • Patient History: A discussion about your symptoms, daily activities, and any prior injuries will help in identifying the cause of your shoulder condition.
  • Imaging Tests: X-rays may be taken to rule out other issues, such as bone spurs, that may be contributing to impingement. An MRI or ultrasound may be used to provide a more detailed view of the soft tissues, tendons, and bursa to check for inflammation or tears.

An early diagnosis is crucial for preventing this condition from worsening and for creating a tailored treatment plan.

TREATMENT OPTIONS FOR SHOULDER IMPINGEMENT AND BURSITIS

There are various treatment options for shoulder impingement and bursitis, ranging from conservative approaches to surgical intervention if necessary. Dr. Liddell will create a treatment plan based on the severity of your symptoms.

Non-Surgical Treatments

In most cases, non-surgical treatments are the first step in managing shoulder impingement and bursitis. These options aim to reduce pain and inflammation, improve mobility, and restore shoulder function and include:

Over-the-counter anti-inflammatory medications (NSAIDs), such as ibuprofen, can reduce inflammation and relieve pain in your shoulder.

A physiotherapist will guide you through specific exercises designed to strengthen your shoulder muscles, improve flexibility, and increase range of motion. These exercises help reduce impingement by improving shoulder function.

Avoid repetitive overhead movements and adjust your daily activities to prevent further aggravation of your shoulder. It’s important to rest the shoulder, but not to completely immobilize it, as gentle movement promotes healing.

Perform any prescribed physiotherapy exercises to maintain flexibility and strength in your shoulder. Avoid aggressive or sudden movements that could worsen the condition.

Maintain good posture, especially when sitting or standing for extended periods, to avoid placing unnecessary strain on your shoulder joint.

Rest your shoulder to prevent further irritation, and apply ice packs for 15-20 minutes several times a day to reduce swelling and relieve pain.

If inflammation is causing significant pain, corticosteroid injections into the shoulder can help reduce swelling and provide temporary pain relief.

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Surgical Treatments

If non-surgical treatments don’t provide sufficient relief, surgery may be recommended:

  • Subacromial Decompression: This procedure involves removing a small part of the shoulder blade (acromion) or bone spurs to create more space for the rotator cuff tendons, reducing impingement. 
  • Bursectomy (Bursa Removal): If bursitis persists, the inflamed bursa can be surgically removed. The bursa typically regenerates in a healthier state after the surgery, allowing the shoulder to move freely without pain.

If your shoulder pain persists for more than a few weeks or worsens over time, it’s important to see Your General Practitioner who may need to refer you to an orthopaedic surgeon. Early treatment can prevent further damage and help you regain your shoulder’s strength and flexibility. Dr Liddell can provide a comprehensive evaluation and recommend a treatment plan tailored to your needs.

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