*For a description of the bursa, see the blog titled “The Shoulder Explained”.
Bursitis is when the normally slippery, smooth bursa becomes inflamed. When this happens, it loses the ability to aid with smooth gliding and the extra size when it becomes swollen causes an already cramped area to become more cramped.
CAUSES: Bursitis is usually caused by chronic pressure or repetitive movement. Acute forms, however, may be triggered when a bursa is injured from a direct blow. Chronic bursitis usually develops over time while acute bursitis develops immediately.
SIGNS/SYMPTOMS: The shoulder will be painful to the touch, swollen, and warm over the inflamed bursa. Usually the pain is felt over the outside top of the shoulder and is often described as a constant, dull, throbbing pain. There will also be pain with movement of the shoulder.
DIAGNOSIS: Usually examiners can diagnosis bursitis with a physical exam using the above signs and symptoms. An MRI is a more definitive way to diagnose the exact location and severity.
TREATMENT: Since bursitis is from inflammation, basic protocols for inflammation such as rest, ice (about 15 minutes at a time), compression, and elevation (RICE) help with the problem. Don’t heat bursitis because it will cause the bursa to become more inflamed. To avoid chronicity, the patient should avoid the activity that causes the bursitis. Chiropractors may need to adjust surrounding joints to prevent the bursa from continuing to become inflamed. Low level laser therapy (LLLT) also may afford relief by decreasing inflammation and pain. Any kind of anti-inflammatory (whether it is natural or synthetic) can also help. There are some circumstances where the bursa may need to be drained. Learning proper stretching and strengthening can help to avoid future flare-ups and chronicity. Antibiotics may need to be given if the bursa becomes infected.
COMPLICATIONS: Occasionally the bursa may become infected. In rare cases, chronic bursitis may need to be treated with surgery.
PROGNOSIS: The outcome after treatment is good if the patient takes the steps necessary to avoid the causative action. Without further steps taken, the bursitis will most likely continue to return.