Subacromial Bursitis: Understanding Shoulder Pain and How Osteopathy Can Help
Shoulder pain that strikes when you reach overhead or to the side can be both sharp and debilitating. One of the common causes of this type of pain is subacromial bursitis, a condition involving inflammation of a small, fluid-filled sac in your shoulder joint.
While painful, this condition often responds well to conservative care. Osteopathy offers a holistic approach to managing subacromial bursitis, focusing on reducing inflammation and addressing the underlying biomechanical issues that caused it.
Key Facts About Subacromial Bursitis
The subacromial bursa is a small, fluid-filled sac that acts as a cushion between the tendons of the rotator cuff and the bony arch (acromion) above them. Subacromial bursitis is often part of a broader condition known as subacromial pain syndrome (SAPS), which can also involve rotator cuff tendinopathy. It frequently affects people who perform repetitive overhead motions in their job or sport.
Common Causes of Subacromial Bursitis
Repetitive Overhead Activity: Jobs or sports involving frequent reaching or lifting (e.g., painting, swimming, tennis, weightlifting) can cause friction and pinching of the bursa.
Shoulder Impingement: When the space under the acromion bone narrows due to poor shoulder mechanics, muscle weakness, or bony changes, leading to compression of the bursa and tendons.
Acute Injury: A direct fall onto the shoulder or abrupt, forceful movement can trigger acute inflammation.
Poor Posture: Rounded shoulders and forward head posture can alter shoulder blade position and reduce the subacromial space.
Muscle Imbalances: Weakness in the rotator cuff and scapular stabiliser muscles can cause the humeral head to ride up, pinching the bursa.
Common Signs and Symptoms
Aching or sharp pain on the outside and front of the shoulder, possibly radiating down the upper arm. A painful arc where pain is worst lifting the arm out to the side between 60 and 120 degrees. Night pain worsening when lying on the affected side. Tenderness when pressing on the front or top of the shoulder. Reduced range of motion and difficulty reaching behind the back or overhead.
How Can Osteopathy Help?
Osteopathic management focuses on reducing inflammation, restoring normal shoulder mechanics, and addressing root causes to prevent recurrence. We look at the body as an integrated system, as issues in the neck and upper back can significantly impact the shoulder.
During the initial consultation, we take a detailed history, perform a physical examination with specific orthopaedic tests, and conduct a postural and biomechanical assessment of the neck, upper back, and shoulder blade. Treatment includes: reducing pain using gentle techniques to improve circulation and lymphatic drainage; soft tissue massage to tight muscles; improving joint mobility through mobilisation of the shoulder, clavicle, neck, and upper back; correcting scapular positioning to create more room for the bursa and tendons; addressing contributing neck and upper back dysfunctions; and providing personalised activity modification, postural advice, ergonomic guidance, and a progressive exercise program.
When to Seek Immediate Medical Help
Please consult your GP or seek urgent care for signs of infection (fever, chills, hot and very painful shoulder), severe disabling pain with sudden onset, a deformed shoulder after trauma, or significant weakness or numbness radiating down the arm.
Disclaimer: This blog post provides general information only and is not intended as a substitute for professional health advice, diagnosis, or treatment. Always consult a registered health practitioner for diagnosis and treatment of health conditions. Individual results from osteopathic treatment may vary. In cases of suspected infection (septic bursitis), immediate medical attention is required.
