Shoulder bursitis is one of the most common findings that show up on a shoulder ultrasound. But what exactly is shoulder bursitis?
A bursa is a small fluid-filled sac that helps reduce friction between structures in many joints throughout the body. The shoulder has five different bursae. When a bursa becomes inflamed, it is referred to as bursitis- with “itis” meaning inflammation. In the shoulder, the most commonly affected bursa is the subacromial bursa, hence the term subacromial bursitis.
Symptom vs Root Cause
It is common for shoulder bursitis to develop secondary to other shoulder conditions. For this reason, it is often described as a symptom rather than the root cause of shoulder pain. This means that simply treating the bursitis may provide limited relief if the underlying cause is not also addressed.
The Concept of Asymptomatic vs Symptomatic Findings
When a scan is performed on a pain-free, healthy shoulder, structural abnormalities are often found – bursitis being one of the most common. A finding that is present but not causing pain is referred to as an asymptomatic finding. In contrast, a finding that is responsible for the pain is considered symptomatic.
This highlights the importance of clinical reasoning: when scanning a painful shoulder, it is essential to determine which findings are asymptomatic and which are symptomatic in order to accurately treat the issue.
Symptomatic or Asymptomatic? Symptom or Root Cause? How Do You Tell?
The only way to identify the root cause is through a thorough clinical assessment. Consider the following questions:
- What triggered the pain?
- Did the pain come on suddenly or gradually?
- Where is the pain located?
- What movements or activities aggravate the shoulder?
- What helps ease the pain?
- Are there any other signs or symptoms present?
- How long has the issue been ongoing?
- What treatments have been tried? What has helped? What hasn’t?
Summary
Understanding the true nature of shoulder bursitis- whether it’s a symptom or a cause, symptomatic or asymptomatic- is crucial in guiding treatment and achieving lasting results. If you’re struggling with shoulder pain and have been told you have shoulder bursitis or suspect shoulder bursitis, book an appointment with one of our physiotherapists for a detailed assessment and tailored treatment plan.
