Subacromial and Subdeltoid Bursitis)
The shoulder joint is made up of three bones: the shoulder blade (scapula), the collarbone (clavicle) and the upper arm bone (humerus). The shoulder is one of the most mobile joints in the body and it is a "ball and socket" joint, which holds the ball (the top, rounded part of the humerus) in the socket (the shallow, depressed area called the glenoid cavity, located on the outer edge of the scapula).
The rotator cuff muscles (supraspinatus, subscapularis, teres minor, and infraspinatus) are connected individually to a group of flat tendons, which fuse together and surround the front, the back, and the top of the shoulder joint like a cuff on a shirt. The tendons attach the muscles to the bone and allow movement in the shoulder, as well as providing strength to hold the ball in its socket.
The rotator cuff ligaments attach bone to bone and provide stability to the shoulder joint bones.
Between the bones, muscle and other soft tissue are bursae (fluid filled sacs) and synovial fluid (lubricates your joint), which permit smooth gliding between the joint. They also protect the rotator cuff from the bony spurs or arches on the shoulder blade.
Overstraining the rotator cuff can lead to inflammation in your joint, which can result in tendinitis and bursitis. You can experience these conditions independently or simultaneously. This mild inflammation can cause your shoulder tendons and bursa to swell and rub against or snag the acromion, or rub against a ligament at the front of your shoulder. When your arm is raised in a forward, reaching or overhead position the shoulder tendons and bursa can be pinched (impingement), which causes further swelling. Failure to take action against the inflammation can cause further degeneration in the shoulder tendons and bursae which may result in a major rotator cuff strain and/or tear.
How to Treat Shoulder Bursitis
Relieving the symptoms of bursitis initially focuses on keeping the pressure off the bursa (i.e. carrying a backpack or purse on the opposite shoulder). Surgery may be required if your bursa irritation is a result of a bone formation problem, such as a hooked acromion causing impingement of the bursa. If your bursitis is caused by an infection (septic bursitis), the doctor will probably drain the bursa sac with a needle and prescribe antibiotics to treat the infection.
For non-infectious bursitis, the preliminary treatment starts with non-operative options such as cold therapy. Surgery to remove the inflamed bursa is normally not required for bursitis, however if you fail to see improvement with the conservative treatments, your physician may recommend surgery to remove the bursa completely. Although this removes the problem of an inflamed bursa, you are left with less cushioning in your rotator cuff which can lead to a host of other shoulder pain and problems.
The most important factor in healing bursitis is resting your shoulder. This can be difficult when you have to carry on with daily activities, but resting your shoulder whenever you can is recommended. During your recovery you will probably have to modify or avoid the activities that stress your bursa until your pain and inflammation settle.
Treatments should involve decreasing swelling, relieving stress on the shoulder, correcting any biomechanical dysfunction (hooked acromion, bone spur, etc.), treating scar tissue, and then restoring strength and movement in your shoulder.
Cold Compression Therapy
To decrease inflammation and relieve the pain of rotator cuff bursitis doctor's recommend cold therapy.
Applying cold to your inflamed bursa will help decrease the swelling and redness around it. Cold therapy will also help to numb the pain in your shoulder and rotator cuff and help to control the inflammation.
Cooling your inflamed bursa as needed throughout the day is recommended. Do not apply ice directly on your skin, rather wrap it in a cloth or towel or, better yet, use a cold wrap that fits easily and comfortably to your body.
The Shoulder Freezie Wrap® has a supercharged cooling gel pack that chills in the fridge, not in the freezer like ice or other freezer packs, giving you deep cold therapy without the risk of 'cold burns' or cryoburn. It can be used to apply cold in a safe, convenient and effective way - and the gel pack is reusable.
The wrap is soft and adjustable so it fits your shoulder properly, without irritating the bursa, and allows you to adjust the compression. This is important when treating an inflamed bursa because too much pressure can cause you further pain. You control how much pressure the bursa receives so you can benefit from the compression to hold the cold where you need it, without increasing your pain.
Applying cold to your tender bursa and rotator cuff is the first step in treating your bursitis. Then begin Blood Flow Stimulation Therapy™ to continue the healing process.
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Blood Flow Stimulation Therapy™
Once the inflammation of your bursitis has been reduced with cold therapy it is time to improve blood flow and improve the elasticity of your surrounding soft tissue. Your body needs a fresh supply of blood to improve the health of your tissue and get your bursae and rotator cuff tendons healthy again.
Unfortunately, when you are suffering from bursitis it is painful to lift your arm and use you shoulder. When you limit movement in your shoulder the blood flow is reduced, starving your tissue of the necessary oxygen and nutrients.
The trick is to find a way to increase blood flow without causing pain and/or further inflaming the bursae. This is where Blood Flow Stimulation Therapy™ (BFST®) becomes a powerful tool. BFST® compliments your body's natural healing process by promoting the flow of blood to your shoulder while you give it the rest it needs.
The Shoulder Inferno Wrap® uses a patented process to generate the same energy that is part of the sun's spectrum of light, the same energy that is necessary to all living things for optimum health. The energy emitted from the Energy Web® stimulates blood flow to your rotator cuff, more than your body would ever be able to generate on it's own, giving your body the boost it needs to continue the reconditioning process. The healing energy reaches deep into your shoulder bursae and rotator cuff tendons to speed tissue repair, whisk away the toxins and dead cells, and rejuvenate your rotator cuff tissues for improved elasticity.
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With these easy-to-use, home therapies you will notice significantly reduced pain and an incredible improvement in your rotator cuff range of motion.
We recommend that you consult your doctor and/or physiotherapist before using any of our outstanding products, to make sure they're right for you and your condition.
Pain and Anti-inflammatory
(NSAIDs - Non-steroidal anti-inflammatory drugs) can be used if required to help manage your pain. However, these aren't recommended for long term use, as they can cause gastrointestinal difficulties and increase the risk of cardiovascular disease. The use of cold therapy and BFST® in conjunction with NSAIDs can greatly improve the effect of this medication and can help to heal quicker.
Your doctor may aspirate the inflamed bursa. This involves removing the extra fluid that has built up with a needle. Sometimes, the fluid will be tested at a laboratory to rule out infection.
If your bursitis does not get better with conservative treatments, a subacromial decompression may be done. It is an arthroscopic procedure, so tine incisions are made and a pencil-sized camera is inserted into the shoulder. A small shaver is inserted into another incision, and is used to remove the swollen bursa all together. The surgeon will then look for any damage to the rotator cuff. If the subacromial space is small, the surgeon may use a burr to shave the acromion down in order to create more space for the rotator cuff tendons. This is also done to remove any bone spurs in the shoulder.
Recovery time for the surgery will depend a number of different factors including your healing ability, diet, rest and how many procedures were done in your surgery. Your doctor will advise you on your recovery, and will let you know if/when physical therapy can be started.
Please be aware that this information is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider before starting any new treatment or with any questions you may have regarding a medical condition.