SHOULDER BURSITIS, SUBACROMIAL
(Subdeltoid Bursitis)
DESCRIPTIONSubacromial shoulder bursitis refers to inflammation of the subdeltoid bursa, one of the important bursas of the shoulder. Bursitis develops slowly and may vary in degree from mild irritation to an abscess formation that causes excruciating pain. Appropriate health care includes: doctor's diagnosis and treatment; surgery (sometimes) in worse cases, particularly for a frozen shoulder.
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 FACTORS
Participation in competitive athletics, particularly contact sports such as football, especially if protective equipment is inadequate; 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.
PREVENTING COMPLICATIONS OR RECURRENCEInstructions for your child:
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.
BASIC INFORMATION
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; X-rays of the child's shoulder.
POSSIBLE COMPLICATIONSFrozen shoulder, with temporary or permanent limitation of the shoulder's normal mobility; prolonged healing time if the child resumes activity too soon; proneness to repeated flare-ups; an 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.
TREATMENT
HOME CARE
Use frequent 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 to the child. 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 child's shoulder joint, if needed.
Elevate the shoulder above the level of the child's heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping.
Gentle massage will frequently provide comfort and decrease swelling.
Urge your child to do the rehabilitation exercises prescribed by your doctor.
MEDICATION
Your 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.
ACTIVITY
Instructions for your child:
Rest 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.
DIET & FLUIDS
Your child should eat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk, and eggs. Increasing fiber and fluid intake helps prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of shoulder bursitis; pain increases despite treatment; pain, swelling, tenderness, drainage, or bleeding increases in the surgical area; your child develops 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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