Subacromial Bursitis

Anatomy

The subacromial bursa is a sac that protects and covers the rotator cuff.  It is positioned between the cuff and the acromion, an archway of bone at the top of the shoulder.  It allows for smooth gliding of rotator cuff tendons beneath the acromion.

The Problem

Subacromial bursitis is included in the broad spectrum of problems referred to as rotator cuff injuries.  The bursa can become inflamed, often as the result of shoulder impingement, in which bursal and rotator cuff tissues become pinched against the acromion.  This is most likely to occur with repetitive overhead reaching or lifting.

Subacromial bursitis can result in tenderness in the front of the shoulder, pain with shoulder motion, particularly overhead, and decreased shoulder motion.

Treatment

Treatment involves the use of ice, anti-inflammatory medications, avoidance of painful shoulder positions and physical therapy.  Subacromial steroid injections can be a useful treatment, delivering powerful anti-inflammatory medication to the site of the problem.  Injections are generally considered if pain continues after other non-surgical measures have been carried out.  Injections can also be useful to decrease pain and inflammation early on, if those problems would otherwise prevent a patient from being able to tolerate an aggressive course of therapy.