Sub-acromial Bursitis


Subacromial bursitis refers to the inflammation of the subacromial bursa, a small fluid-filled sac located between the rotator cuff tendons and the acromion (a bony prominence of the shoulder blade). The primary role of bursae in the body is to reduce friction and provide a smooth gliding surface between bones, tendons, and muscles.

In the context of the shoulder, the subacromial bursa helps prevent friction between the rotator cuff tendons and the acromion during shoulder movement. When the bursa becomes inflamed, it can lead to subacromial bursitis, causing pain, swelling, and discomfort in the shoulder.

Common causes of subacromial bursitis include repetitive overhead arm movements, injury, or underlying conditions such as rotator cuff tendonitis or impingement syndrome. Symptoms may include pain with arm movement, swelling, and tenderness in the affected area.

Clinical Presentation

The clinical presentation of subacromial bursitis involves a set of symptoms related to inflammation of the subacromial bursa. Here are common features of subacromial bursitis:

  • Shoulder Pain: Pain is typically felt on the outer side or top of the shoulder and may be more pronounced during activities that involve raising the arm, reaching overhead, or lifting objects. Pain may also be present at rest, especially during sleep, particularly when lying on the affected side.
  • Painful Arc of Motion: There may be a specific range of motion where the pain is most intense, often referred to as a “painful arc.”  Pain may be felt when lifting the arm to a certain angle.
  • Weakness: Some individuals may experience weakness in the affected shoulder due to pain and limited mobility.

It’s important to note that the symptoms of subacromial bursitis can overlap with other shoulder conditions, such as rotator cuff injuries or impingement syndrome. A healthcare professional, often an orthopaedic specialist, can make a diagnosis based on a thorough examination, medical history, and, if needed, imaging studies like X-rays or MRI. Treatment typically involves a combination of rest, anti-inflammatory medications, physical therapy, and, in some cases, corticosteroid injections.

Treatment Options

The treatment of subacromial bursitis typically involves a combination of conservative measures to reduce inflammation, alleviate pain, and promote healing. Here are common treatment options:

  • Rest and Activity Modification:
    • Resting the affected shoulder and avoiding activities that worsen symptoms can help in the initial phase of recovery.
  • Anti-Inflammatory Medications:
    • Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, can help reduce pain and inflammation.
  • Physiotherapy:
    • Physiotherapy is often prescribed to strengthen the shoulder muscles, improve range of motion, and correct any biomechanical issues contributing to the condition.
  • Corticosteroid Injections:
    • In some cases, a healthcare professional may administer corticosteroid injections into the subacromial space to reduce inflammation and provide short-term pain relief.
  • Surgical Treatment:
    • Surgery is rarely indicated for the treatment of primary sub-acromial bursitis.  

Occasionally however, surgery to remove the bursa (Bursectomy), and to create more space for the rotator cuff to function (sub-acromial decompression) may be indicated. Such circumstances may include the presence of calcium deposits in the tendon or bursa, the development of sub-acromial spurs, or the failure of conservative treatments. 

To schedule an appointment with Dr Matthew Evans to discuss your Sub-acromial Bursitis, please contact us by phone – (03) 9529 3820, or email

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