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Shoulder bursitis and impingement

Shoulder bursitis is an injury or inflammation of the bursa around the shoulder joint. A bursa is a tiny, fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body.

During impingement caused by bursitis, this space becomes too narrow to accommodate the tendons and the bursa. Therefore, every time these structures move between the bones, they are pinched. Shoulder pain from bursitis is common in both young athletes and middle-aged people. Repetitive lifting or overhead activities also increases susceptibility to injury. Sometimes after an initial injury that sets off the process of inflammation, the problem can become self-exacerbating, and the tendons and bursa can become inflamed. This inflammation causes a thickening of these structures, which then takes up more space, causing even further pinching of the tendons and bursa.

A thorough physical exam is important to diagnose bursitis, and making an accurate diagnosis is necessary for proper treatment. X-rays are typically performed to assess the bony anatomy of the shoulder and can sometimes detect calcifications in the bursa when bursitis has been chronic or recurrent. An MRI may be considered to define bursitis and to ensure there is no sign of a rotator cuff tear.

In many cases, the initial treatment for shoulder bursitis is non-surgical and may take several weeks or months for gradual improvement and return to full function.

Working with an experienced physical therapist is highly recommended. They will attempt to restore normal motion to your shoulder by providing you with specific stretching exercises to improve your range of motion, relieve pain, and strengthen your muscles.

The surgical procedure for treating shoulder bursitis by removing the inflamed bursa is called a bursectomy.

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