What is Shoulder Bursitis?
What is Subacromial Bursitis?
Bursae in the Shoulder
Bursae (plural for bursa) are flattened sacs of fluid that function as cushions between your bones and the muscles (deep bursae) or bones and tendons (superficial bursae) to reduce friction and allow your soft tissue to slide over bone easily during muscle contraction. They are lined with synovial cells that secret fluid, rich in protein and collagen, and act as the lubricant between areas in your body where friction (rubbing) is greatest.
In amongst your bones, muscles and tendons in the shoulder there are 8 bursae, the most of any single joint in your body. The major bursae in your shoulder include: the subscapular bursa, the subdeltoid bursa, the subacromial bursa, and the subcoracoid bursa. The subscapular bursa is located between the tendon of the subscapularis muscle and the shoulder joint capsule. The subcoracoid bursa sits between the coracoid process of the scapula and the shoulder joint capsule. The subacromial bursa is situated below the acromion process and above the greater tubercle of the humerus lessening the friction when you move your arm or raise it overhead. The subdeltoid bursa is located between the deltoid muscle and the shoulder joint cavity and is usually joined to the subacromial bursa.
When pressure or friction is too great, excess fluid can build up in the bursa sac causing swelling and inflammation. When a bursa becomes inflamed, moving the shoulder becomes very painful and movement can be difficult. Any actions that put pressure on the inflamed bursa can increase irritation and cause further inflammation and pain.
Your bursae play an important role in leading a healthy, active life. When the bursae are not irritated and working properly, your joints move smoothly and painlessly. However, when a bursa becomes swollen and inflamed, the condition is known as bursitis. As you know, when you suffer from bursitis you will experience pain during physical activity.
Understanding Shoulder Bursitis
Although all of the bursa in the shoulder can become inflamed due to trauma, infection or other conditions, the subacromial bursa is the most commonly inflamed. Frequently, bursitis in the subacromial bursa occurs with tendonitis in the supraspinatus tendon, although you can experience these conditions independently. Since the subacromial bursa and subdeltoid bursa are usually joined together, inflammation in one usually results in inflammation of the other. Overstraining, infection, abnormal bone growth or trauma in the rotator cuff can cause rubbing in your shoulder joint, inflaming the tissue in the area.
Even mild inflammation of your tendons or bursa can produce redness, swelling, and soreness. Failure to treat the inflammation can lead to bursitis and/or tendonitis. If this occurs, the bursa or tendon can become enlarged and the area between the acromion process and the top of the humerus (the subacromial space) may decrease causing the bursa or tendon to rub against the acromion.
If the space becomes too crowded, the acromion can begin to pinch the bursa or tendon (impingement) when your arm is raised in a forward reaching or overhead position causing further irritation and swelling.
This condition is often referred to as swimmer's shoulder, pitcher's shoulder, tennis shoulder, or shoulder impingement syndrome. This impingement can cause further inflammation in the bursa. In addition, degeneration of the tendon can occur which frequently results in a major rotator cuff strain and/or tear. If this continues, your pain will get worse and your tendon may split or completely tear away from the bone. Without prompt, proper treatment of bursitis with cold compression therapy and Blood Flow Stimulation Therapy™ to heal the tissue, you may experience severe tissue damage and surgery may be necessary.
Bursitis in the shoulder is often due to overuse or repetitive actions common in athletes or workers who use frequent overhead arm movements such as throwing a ball, swinging a racquet, swimming, lifting weights, dusting high shelves, painting, or completing manual labor tasks. It can also be a result of something as simple as an awkward fall or trying to lift something up high with a weakened shoulder.
People most susceptible to shoulder bursitis are older than 40 years of age and/or have bone spurs on one of their shoulder bones. However, these injuries can also affect younger people who often partake in new or repetitive activities, are already injured, and/or have chronic weakness in their shoulder.
What are the Symptoms of Shoulder Bursitis?
The symptoms of subacromial bursitis are similar to the symptoms of bursitis that occur in other joints in the body; pain, limited range of motion, weakness, difficulties sleeping, swelling and tenderness, and possibly a fever if the bursa is infected.
Direct pressure on the bursa will exacerbate the pain and should be avoided if possible. Subdeltoid or subacromial bursitis causes pain when you move your shoulder, particularly during activities requiring abduction and extension.
To diagnose your bursitis, the doctor may ask you to extend your arm out and he/she will apply resistance as you try to move it back towards your body. If the pain increases you may be suffering from bursitis, although other rotator cuff injuries and tendonitis can produce similar pain patterns.
The pain of bursitis starts gradually, originating deep inside your shoulder, and develops over a few days or even months. You will usually feel the pain on the outside of the shoulder and it may spread down the outer arm towards the elbow. If you raise your arm above your head, as you would when washing your hair or reaching high to get something off a shelf, the pain will worsen.
If the bursa is swollen and pinched by the acromion (Impingement Syndrome) the pain might happen when you lift your arm out to the side.
If your bursitis is caused by an infection in the bursa (septic bursa) you will usually experience a fever. If you are experiencing tenderness, warmth, and redness around the bursa, it is recommeded that you see a doctor for medication to get rid of the infection.
Limited Range of Motion and Weakness
When you have subacromial bursitis, the pain often limits your range of motion in the shoulder as you stop performing motions that make the pain worse. If bursitis is left untreated the inflammation can increase, causing more pain, limiting movement even more. Eventually weakness in the shoulder muscles and tendons can set in.
Patients suffering from shoulder bursitis may also have interrupted sleep patterns. Simply rolling over on the affected shoulder during the night can cause pressure on the inflamed bursa increasing the pain at the pressure point. The pain can range from mild to very sharp depending on the amount of inflammation in your shoulder.
Tenderness and Swelling
A physical examination of your shoulder will show tenderness and usually warmth and swelling of the bursa and possibly the tendons as well. The tenderness will appear over the outside (lateral) shoulder and the subacromial space. There may be redness on your skin over the area.
It is important to treat bursitis to reduce these symptoms, minimize damage and maintain rotator cuff motion and strength. Without proper care, you may experience other painful conditions such as calcific tendonitis, frozen shoulder or a rotator cuff tear. By treating your shoulder bursitis in the early stages, you are more likely to prevent long-term damage and chronic conditions from setting in.
How Do I Diagnose Shoulder Tendonitis?
Visiting your doctor when you have shoulder pain is always recommended, as there are many possible issues that can happen within the shoulder. Sometimes, one set of symptoms can result in multiple diagnoses. An x-ray or MRI is often needed in order to diagnose if the shoulder is out of alignment or the extent of the soft tissue damage.
To begin with, your doctor will gather a medical history about you and your current condition and symptoms. He/she will inquire about the intensity of your present pain, the duration of your symptoms and the limitations you are experiencing. Details about what instigated the problem, when it started, and whether or not you have ever had treatments for this or a similar condition in the past, are very helpful in assessing your injury.
A physical examination will be performed to determine if you have any signs of shoulder bursitis or other shoulder injury. He/she will visually assess and palpate (feel) the bones and soft tissue in both your shoulders to evaluate symmetry to recognize any differences. This will identify any abnormalities, such as mild or severe inflammation, bone deformities, atrophied muscles, redness and/or warmth on the skin.
You will generally be asked to complete a series of movements to measure your active (performed by you) and passive (performed by your examiner) range of motion. These movements will test any possible shoulder impingements, as well as your shoulder strength, joint stability, and location of tenderness. A sign that you may have subacromial bursitis is acute pain when trying to reach the affected arm behind you towards the lower back, as if to get something out of your back pocket. You would also experience pain when reaching above your head, as you would when putting something on a high shelf. If you feel sharp pain with both of these motions you may have shoulder bursitis and/or other related conditions and should see a doctor.
Although rare, subacromial bursitis can be caused by an infection which is potentially serious. Your doctor will be able to rule this out as a possible cause.
What Causes Shoulder Bursitis?
People older than 40 years of age are most susceptible to shoulder overuse injuries, which can easily lead to bursitis. Younger people who participate in repetitive activities, are already injured, and/or have chronic weakness in the shoulder are also at greater risk of experiencing bursitis. There is also a higher incidence of shoulder injuries among women.
Bursitis in the shoulder is often referred to as Swimmer's Shoulder, Pitcher's Shoulder, Tennis Shoulder, or Shoulder Impingement Syndrome.
Repetitive Shoulder Movements
Repetitive overhead shoulder movements, especially if they are weight bearing, may cause fatigue or general weakness in the shoulder muscles and tendons. As a result, your shoulder joint could become misaligned causing more pressure on the subacromial bursa.
This overstraining can lead to inflammation in your joint, which can result in tendinitis and bursitis. You can experience these conditions independently or simultaneously. Without prompt treatment of inflammation in the rotator cuff, impingement (pinching of the tendon and bursa) may occur and cause degeneration in the tendon.
Acute tendonitis is often due to overuse or repetitive actions common in athletes or workers who use frequent overhead arm movements such as throwing a ball, swinging a racquet, swimming, lifting weights, dusting high shelves, painting, or completing manual labor tasks.
Inflammation of your shoulder tendons or bursa will produce redness, swelling, and soreness in your shoulder soft tissue. This inflammation can cause your shoulder tendons and bursa to rub against or snag the acromion, or rub against a ligament at the front of your shoulder. When your arm is raised in a forward, reaching or overhead position the shoulder tendons and bursa can be pinched (impingement), which causes further swelling and irritation.
Impingement syndrome can damage your bursa and/or cause the tendon to break down near its attachment on the humerus bone further increasing inflammation and swelling. If this continues, your bursa pain will get worse and your tendon may split or completely tear away from the bone.
Abnormal Conditions in the Shoulder
If you are suffering or have suffered from other shoulder problems such as bone spurs, a hooked acromion, and/or impingement syndrome your subacromial bursa is at risk of becoming irritated and inflamed. Decreased space in your shoulder joint resulting from anatomical differences in the shape of your shoulder bone will trigger pain, limit the use of your shoulder, and can lead to chronic tendonitis or bursitis if left untreated.
Calcification of the bursa sac can also cause inflammation from within the bursa.
Do You Really have Shoulder Bursitis?
Pain, swelling and inflammation in your shoulder could mean that you have shoulder bursitis. It's also important to consider that there are other conditions that might cause pain in your shoulder as well. Our shoulders are very complicated joints with 6 major bones, ligaments connecting the bones, muscles in the front, back, top and side of our shoulders and tendons connecting those muscles to bone. With so many parts to the shoulder you can easily have a different injury than bursitis, or even suffer from more than 1 injury at a time.
Some other shoulder injuries include: shoulder tendonitis, impingement syndrome, and frozen shoulder.
Shoulder tendonitis (tendinitis) usually causes pain and tenderness in the side and front of the shoulder. If you have shoulder tendonitis you may also have an inability to move your arm or hold it in different positions. Other common symptoms of this injury include pain or a dull ache in your shoulder and/or upper arm, pain when using your arm (either reaching around your body to the front, side, back or overhead), pain that radiates down your arm. The injured area could be red, swollen, or hot the the touch.
Severe tendonitis in your shoulder (possibly from a tendon rupture or ruptured tendon) could result in pain when sleeping at night (especially when laying on the affected shoulder), increased pain first thing in the morning, and general weakness or instability in your shoulder joint.
Anyone can suffer from tendonitis, but it's most common in adults due to degeneration of tissue as we age. Over time the tendons in the foot will wear down resulting in something called degeneration. This is where the fibers in your tendons will become more weak - it's just a natural process that happens as we age.
Like with shoulder bursitis - there are different kinds of tendonitis that you can suffer from. You might have overuse tendonitis, calcific tendonitis (from a calcium deposit or bone spur). You might also have tendonitis in different areas of the shoulder - like biceps tendonitis or supraspinatus tendonitis (rotator cuff tendonitis).
Impingement syndrome happens when the tendons or bursa in your shoulder get caught by the bones in your shoulder. Over time if left untreated impingement syndrome can result in shoulder tendonitis, bursitis and can cause tearing in your rotator cuff tendons. Like shoulder tendonitis, impingement syndrome can happen from repeated overhead activity or movement like painting, lifting, swimming and any other overhead sport.
There are generally 3 stages in impingement syndrome: Stage 1 (pain, swelling and inflammation in the rotator cuff tendons), Stage 2 (rotator cuff tendonitis) and Stage 3 (tendon tissue catching under your bone resulting in immobility and loss of function in your shoulder). Each stage will generally affect a different age group, which is why this condition is thought to progress over time. Stage 1 usually affects individuals younger than 25 years old, Stage 2 affects individuals between the ages of 25 and 40, and Stage 3 affects individuals 40+ (reference: 1).
Frozen shoulder (also known as "adhesive capsulitis") is signified by pain and stiffness in the shoulder joint; limited range of motion and pain while sleeping. This is a condition that commonly occurs in older athletes. Frozen shoulder is five times more common in people with diabetes, though the reason for this is unknown. A lining of fibrous tissue, known as a capsule, surrounds the shoulder joint. The capsule is fully stretched when the arm is raised above the head, and it hangs down as a small pouch when the arm is lowered.
Frozen shoulder happens when this lining becomes thickened and swollen. It's possible that frozen shoulder will happen as a result of a previous injury (like shoulder tendonitis), but it can also happen for no apparent reason or may be triggered by a mild injury in the shoulder area. There are 3 phases to this condition: "Freezing" (general pain, swelling and inflammation), "Frozen" (stiffness in your shoulder) and "Thawing" (recovery as pain eases and most of the movement returns). This process will take some time to get through, and can sometimes take as long as 2 or more years to complete.
How Do You Treat Shoulder Bursitis?
What You Can Do!
The good news is that most cases of shoulder bursitis will heal with simple home conservative treatments and surgery is often not needed!
First you need to stop the activity that is causing your pain and rest your shoulder. Focus on treating the symptoms of your bursitis and any other soft tissue injuries you may have in your shoulder. Make sure to completely reduce inflammation, tenderness and swelling-induced pain first before switching to a goal of healing your bursitis injury.
With bursitis injuries, you might feel the swollen and tender feeling for a long time and it will be hard to treat your condition because your bursa will be sensative to all other therapies outside of cold compression. When introducing other therapies make sure to first treat with cold compression to reduce any lingering affects of the inflammation and then an hour or so later give your bursa a soothing BFST® treatment to heal your bursa and the surrounding tissue.
When it comes to temperature therapy what's better to treat your shoulder bursitis - heat or cold?
Cold Compression Therapy with a Shoulder Freezie Wrap®
RICE (Rest, Ice, Compression, Elevation) has been recommended for years by doctors, trainers, and other medical professionals to treat the pain and swelling, chronic pain from injury and after any re-injury. Bursitis injuries need rest and time for the tissue to heal.
Although RICE can help to treat these symptoms, ice and freezer gel packs reach temperatures so low they can cause cryoburn, an ice burn on your skin. The problem is, up until now there hasn't been any other option to treat painful conditions and injuries, so ice and blue gel packs (full of anti-freeze and chemicals) have been the only choice up until now.
Fortunately you no longer have to settle for these ice cold methods that are uncomfortably cold against your skin, provide short term relief, cause ice burns, numb your skin and underlying tissue beyond feeling so you don't even notice the ice burn until it's too late and pool around your injury putting the cold everywhere except for where you need it most.
A Shoulder Freezie Wrap® allows you to treat your shoulder in an effective and convenient way. Our Freezie Wraps® will wrap around your shoulder keeping the cold right over your bursitis injury for the entire length of your treatment. Our food-grade, non-toxic gel packs can be chilled in the fridge or freezer to tailor the amount of cold that you need for your injury. It doesn't matter how you cool it down, because our gel packs are chock full of gel that's designed to cool down into millions of tiny snowflakes. This method of cooling means our gel packs aren't icy-cold and stay flexible even right out of the freezer! The cushioned gel will wrap around your shoulder and it won't budge for the entire treatment period. You'll no longer have to deal with annoying pooling around your shoulder or have to hold a hard block of ice on your injury!
Tailor your treatment to your own level of comfort - use a Shoulder Freezie Wrap® out of the fridge OR freezer. It's important to treat yourself with whatever your body is comfortable with. So if that means you can't handle a lot of cold, then use your cold packs for 10 minutes out of the fridge instead. You'll stil get all the benefits of cold compression therapy but with a treatment that's tailored for your needs. It's as simple as that.
Cold Compression Therapy with a Freezie Wrap® works by stopping and slowing nerve and cell function in the area and reducing swelling that can block blood vessels.
This is important because once blood vessels are blocked or damaged, they can no longer carry oxygenated blood through the tissue and tissue cells begin to break-down. Without cold compression therapy cellular break-down and tissue damage continues as the cells don't get the oxygen they need to survive. By limiting the amount of damage done to your bursa, you also limit the amount of healing that needs to occur. This is a very important step to heal bursitis injuries faster and with less pain! This is why you need to treat your shoulder bursitis pain right after it's hurt, when you notice pain / swelling / inflammation, or directly after a re-injury. Applying a Shoulder Freezie Wrap® right away will stop the damage immediately and unblock your blood vessels to let your body's natural blood flow in to start healing the tissue.
BFST® with a Shoulder Inferno Wrap®
After the inflammation in your bursa has been reduced, providing extra blood flow and helping to heal your damaged bursa is recommended for complete healing.
Using Blood Flow Stimulation Therapy™ (BFST®), will help with your recovery and heal your damaged tissue more completely. BFST® increases the amount of blood that flows naturally to your bursa and soft tissue to nourish your injury, improving elasticity and speeding the healing process. This increased Blood Flow Stimulation Therapy to your bursa is greatly needed.
The only way to get BFST® is through use of a Shoulder Inferno Wrap®. The Shoulder Inferno Wrap® is the only treatment method that improves blood flow and circulation on a deep tissue level. Other methods of warming / heating tissue (hot water bottles, hot baths, etc) will only ever increase blood flow on a surface / skin level. These methods need a LOT of time to even reach your bursae on a deep tissue level. And even if you were to use them this long your skin would heat up to an uncomfortable level and may even burn you.
The best source of heat treatment is from a product where you don't even feel that much heat. When you don't feel the heat, it means the therapy is working in your deep soft tissue which is really where you need it. It's kind of like how your heart works in your body. You can't "feel" your heart pumping blood all around your body to your arms and legs. You can't even hear your own heartbeat without listening very closely. This is exactly how deep tissue BFST® works too! You're not supposed to "feel" a lot of heat because the heat isn't treating your skin, it's treating your damaged bursa by increasing the blood flow right in your soft tissue. Over time with consistent treatments you'll even notice that the warmth you feel from BFST® will decrease. This is a sign that you've successfully increased blood flow right at the source of your pain and your body is doing everything it can to speed up the healing process.
The Shoulder Inferno Wrap® is the only product available anywhere that offers BFST® AND a thin, flexible Energy Web® (heating element) that conforms around your shoulder.
This Energy Web® also provides consistent, uniform heat all around your shoulder to increase blood flow in the entire joint.
Our Shoulder Inferno Wrap® is made from medical-grade material - this should be as important to you as it is to us! Other products that are sold in stores are considered "consumer goods" meaning the material only needs to be as good as a sweater that you wear. Clothing articles like this don't need to meet high standards of production or materials and may include materials that irritate your skin.
Since our wraps are medical-grade products registered with the FDA, they are of a higher quality and need to meet way more standards for manufacturing (ISO 10993 - biocompatibility testing). This makes our wraps the safest product for heating treatment. Our manufacturer has spent years perfecting the wrap design to make sure you get the treatment you deserve!
Our Shoulder Bursitis Therapy Formula
is Proven to Work!
It may seem hard to believe, but our Shoulder Freezie Wrap® and Shoulder Inferno Wrap® home therapy products will assist you in recovering from your shoulder bursitis by maximizing blood flow where it's needed most and reducing your swelling and inflammation induced pain.
Here at AidMyBursa we pride ourselves in helping you with your healing and recovery process. Everyone at AidMyBursa has tested and used the products, finding solutions to conditions that do not fit into the norm. This dedication to our customers and our products goes hand-in-hand with our guarantees to you as a customer:
- Guarantee #1 - Use your products diligently for up to 60 days and you will experience a significant reduction in pain. If not, we encourage you to send back the items for a 100% refund.
- Guarantee #2 - You will not be left in the dark after purchasing any product form us. AidMyBursa Advisers and Product Specialists are available 7 days a week by toll free phone 1.866.237.9608 or email to answer your questions or concerns.
- Guarantee #3 - Your order is guaranteed to be shipped within 24 hours on every business day.
- Guarantee #4 - All purchases receive a one year, full replacement warranty with guaranteed, prompt service.
- Guarantee #5 - You could save hundreds of dollars and possibly more, by utilizing our products, and getting back to work sooner.
Continue the healing process by resting your shoulder. Limit the activities that may be aggravate your shoulder. Without proper rest and limitation on activities, being active as if your shoulder is healthy can lead to re-injury. To get back to doing the things you love you need to give your body proper care and attention. Why risk having to limit or give up your favorite weekend activity, your exercise routine, or even your job due to a bursitis injury?
Prevention and Promotion of Lifelong Health
If you want to avoid re-injury, or manage pain and increase circulation for lifelong health benefits, a Shoulder Freezie Wrap® and Shoulder Inferno Wrap®, will provide exceptional results. Why spend time in pain, off from work, and missing out on your active lifestyle when you can be proactive about your injury and the health of your body? Talk to your doctor about incorporating a regular routine of using a Shoulder Freezie Wrap® and Blood Flow Stimulation Therapy™ into your everyday health regimen.
Call one of our AidMyBursa Advisers at no cost or obligation to address any lingering questions you have about using heat or cold for your shoulder injury - toll free 1-866-237-9608
Learn More About SUPERIOR Bursitis Treatments
Learn more about how the Shoulder Freezie Wrap® is designed to be the most effective cold compression wrap on the market today.
Learn more about how the Shoulder Inferno Wrap® helps with the healing process.