Description

Subacromial bursa is a thin, protective layer of tissue found between the top of the rotator cuff and below the acromion. Bursa exists in an effort to keep the rotator cuff from rubbing on the undersurface of the acromion. Bursa can become inflamed and thickened, decreasing the space between the rotator cuff and the acromion, resulting in symptoms of rotator cuff inflammation.

What are the causes?

Bursitis generally occurs as a result of overuse of the rotator cuff or repetitive overhead motion and less commonly from injury. Patients with occupations that frequently require them to lift their arms over their heads (plumbers, painters, electricians and carpenters) are at risk for bursitis. Athletes who play overhead sports, such as baseball, softball, volleyball and tennis will often develop symptoms as well. Abnormalities in the structure of the acromion (“hooked” acromion) or that have developed AC joint osteoarthritis and associated bone spurs on the underside of the AC joint often have bursitis caused by impingement syndrome.

What are the symptoms?

Bursitis typically causes referred pain on the side of the shoulder, though the inflammation is deep within the shoulder. Patients may feel pain at the AC joint if arthritis is present. Pain at night while sleeping is a common symptom, often leading to the patient to say “I slept on my shoulder wrong”. Pain from bursitis is worse when reaching overhead, across the body or behind the back. Patients may also feel clicking and popping while moving the shoulder.

How is it diagnosed?

Dr. Liu will perform a thorough history and physical exam, which typically includes X-rays of the shoulder. Based on some of the shoulder tests your surgeon performs and the presence of AC joint arthritis or acromion structure abnormality, no further workup is necessary. If your pain is accompanied by a significant loss of strength, indicative of a rotator cuff tear, your surgeon may order an MRI.