SHOULDER BURSITIS, SUBACROMIAL (Subdeltoid Bursitis) |
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General Information
DEFINITION--Inflammation of the subdeltoid bursa, one of the important bursas of the shoulder. Bursitis may vary in degree from mild irritation to an abscess formation that causes excruciating pain.
BODY PARTS INVOLVED
Subacromial bursa (a soft sac filled with lubricating fluid that facilitates motion in the shoulder).
Soft tissue surrounding the shoulder, including nerves, tendons, ligaments, blood vessels (both large vessels and capillaries), periosteum (the outside lining of bone) and muscles.
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SIGNS & SYMPTOMS
Pain in the shoulder area.
Tenderness.
Swelling.
Redness (sometimes) over the affected bursa.
Fever if infection is present.
Limitation of motion in the shoulder.
CAUSES
Injury to the shoulder.
Acute or chronic infection.
Arthritis.
Gout.
Unknown (frequently).
RISK INCREASES WITH
Participation in competitive athletics, particularly contact sports such as football.
Previous history of bursitis in any joint.
Previous shoulder injury involving the "rotator cuff" (See Glossary).
Exposure to cold weather.
Poor conditioning and inadequate warmup.
Inadequate protective equipment in contact sports.
HOW TO PREVENT
Use protective gear for contact sports.
Warm up adequately before athletic practice or competition.
Wear warm clothing in cold weather.
To prevent recurrence, continue to wear extra protection over the shoulder until healing is complete.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis and treatment.
Surgery (sometimes) in worst cases, particularly for a frozen shoulder.
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the shoulder.
POSSIBLE COMPLICATIONS
Frozen shoulder, with temporary or permanent limitation of the shoulder's normal mobility.
Prolonged healing time if activity is resumed too soon.
Proneness to repeated flare-ups.
Unstable or arthritic shoulder following repeated episodes of bursitis.
Spontaneous rupture of bursa if severe infection is present.
PROBABLE OUTCOME
Mild, subdeltoid bursitis is a common--but not a serious -- problem. Symptoms usually subside in 7 to 14 days with treatment. Chronic bursitis in any bursa of the shoulder can cause recurrent flare-ups.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This problem develops slowly.
CONTINUING CARE
Use ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
Apply heat instead of ice, if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments. Sometimes heat makes pain worse. If so, discontinue and use ice only.
Use a sling to support the shoulder joint, if needed.
Elevate the shoulder above the level of the heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping.
Gentle massage will frequently provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
Non-steroidal anti-inflammatory drugs.
Prescription pain relievers for severe pain. Use non-prescription aspirin, acetaminophen or ibuprofen (available under many trade names) for mild pain.
Injections into the inflamed bursa of a long-lasting local anesthetic mixed with a corticosteroid drug, such as triamcinolone.
ACTIVITYRest the inflamed area as much as possible. If you must resume normal activity immediately, wear a sling until the pain becomes more bearable. To prevent a frozen shoulder, begin normal, slow joint movement as soon as possible.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.
REHABILITATIONSee section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have symptoms of shoulder bursitis.
Pain increases despite treatment.
Pain, swelling, tenderness, drainage or bleeding increases in the surgical area.
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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