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
Your Shoulder's Cushion: 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. Its job is to reduce friction during shoulder movement.
Part of a Spectrum: Subacromial bursitis is often part of a broader condition known as subacromial pain syndrome (SAPS), which can also involve rotator cuff tendinopathy.
Common in Overhead Activities: It frequently affects people who perform repetitive overhead motions in their job or sport.
Common Causes of Subacromial Bursitis
The bursa becomes inflamed and painful when it is repeatedly compressed or irritated. Common causes include:
Repetitive Overhead Activity: Jobs or sports that involve frequent reaching or lifting (e.g., painting, swimming, tennis, weightlifting) can cause friction and pinching of the bursa.
Shoulder Impingement: This occurs when the space under the acromion bone narrows, often due to poor shoulder mechanics, muscle weakness, or bony changes, leading to compression of the bursa and tendons during arm elevation.
Acute Injury: A direct fall onto the shoulder or an abrupt, forceful movement can trigger acute inflammation of the bursa.
Poor Posture: Rounded shoulders and a forward head posture, common from desk work, can alter the position of the shoulder blade 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 during movement.
Common Signs and Symptoms
Pain Location: Aching or sharp pain on the outside and front of the shoulder, which may radiate down the upper arm.
Painful Arc: A specific sign where pain is worst when lifting your arm out to the side between 60 and 120 degrees.
Night Pain: Pain that worsens at night, especially when lying on the affected side.
Pain with Pressure: Tenderness when pressing on the front/top of the shoulder.
Stiffness and Weakness: Reduced range of motion and difficulty with activities like reaching behind your back or overhead.
How Can Osteopathy Help with Subacromial Bursitis?
Osteopathic management focuses on reducing inflammation, restoring normal shoulder mechanics, and addressing the root causes to prevent recurrence. We look at your body as an integrated system, as issues in your neck and upper back can significantly impact your shoulder.
During your initial consultation, we will:
Take a detailed history to understand your symptoms, daily activities, and any recent injuries.
Perform a physical examination to assess your shoulder's range of motion, identify painful movements, and conduct specific orthopaedic tests.
Conduct a postural and biomechanical assessment of your neck, upper back (thoracic spine), and shoulder blade (scapula) function.
This comprehensive approach allows us to create a tailored treatment plan.
What Does Osteopathic Treatment Involve?
Using gentle, hands-on techniques, we aim to:
Reduce Pain and Inflammation: While avoiding direct aggressive pressure on the inflamed bursa, we use gentle techniques to improve circulation and lymphatic drainage, which can help reduce swelling. Soft tissue massage is applied to the tight muscles around the shoulder and neck.
Improve Joint Mobility: Gentle mobilisation of the shoulder, collar bone (clavicle), and the joints of the neck and upper back can help restore normal movement and increase the subacromial space.
Correct Scapular Positioning: A key focus is on improving the control and movement of your shoulder blade (scapula). We use techniques to release tight tissues and activate weak muscles to ensure the shoulder blade moves correctly, creating more room for the bursa and tendons.
Address Contributing Factors: We treat dysfunctions in the neck and upper back that may be contributing to poor shoulder mechanics or referring pain to the area.
Provide Personalised Advice and Rehabilitation: You will receive guidance on:
Activity Modification: Temporary adjustments to avoid aggravating movements.
Postural and Ergonomic Advice: For your workstation and daily activities.
Targeted Exercise Program: A progressive program to strengthen your rotator cuff and scapular stabilisers, and improve flexibility, which is crucial for long-term recovery.
When to Seek Immediate Medical Help
While most cases respond well to conservative care, it is vital to rule out more serious conditions. Please consult your GP or seek urgent care if you experience:
Signs of Infection (Septic Bursitis): This includes a fever, chills, and the shoulder being red, hot, and very painful.
Severe, disabling pain that comes on suddenly.
A shoulder that appears deformed or you are unable to move it after a trauma.
Significant weakness or numbness radiating down the arm.
Your GP can provide a definitive diagnosis and may discuss other management options, such as medication or a referral for imaging, if necessary.
Find Relief for Your Shoulder
Living with shoulder pain can limit your life and activities. Osteopathy provides a safe, non-invasive, and drug-free pathway to not only alleviate your pain but also to address the underlying causes and restore your shoulder's healthy function.
Click Here to schedule an appointment with one of our experienced osteopaths. Let us help you get back to moving freely and without pain.
References
*Bureau, N. J., & Cardinal, É. (2009). Imaging of the subacromial space. Seminars in Musculoskeletal Radiology, 13(3), 179-197. [Link: https://www.thieme-connect.com/products/ejournals/abstract/10.1055/s-0029-1224684]*
*Michener, L. A., McClure, P. W., & Karduna, A. R. (2003). Anatomical and biomechanical mechanisms of subacromial impingement syndrome. Clinical Biomechanics, 18(5), 369-379. [Link: https://www.clinbiomech.com/article/S0268-0033(03)00047-0/abstract]*
Australian Institute of Health and Welfare (AIHW). (2020). Musculoskeletal conditions. [Link: https://www.aihw.gov.au/reports/chronic-musculoskeletal-conditions/musculoskeletal-conditions]
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, such as your General Practitioner (GP) or osteopath, for diagnosis and treatment of health conditions. The information provided is based on the best available evidence at the time of publication but should not be relied upon as a sole source of information. Individual results from osteopathic treatment may vary based on the individual’s specific condition and response to care. In cases of suspected infection (septic bursitis), immediate medical attention is required.