Thursday, November 29, 2012

Shoulder Bursitis: How To Treat and Prevent

Bursitis in general means inflammation of the bursa, which is one of the layers of soft tissue that surrounds a joint. It can occur in almost any of your large joints. It is important to have a specific diagnosis of which bursa is inflamed.

Bursitis in the shoulder is technically diagnosed as subacromial bursitis. Shoulder pain can come from many sources, such as impingement syndrome, rotator cuff tendinitis, rotator cuff tear, frozen shoulder, muscle strain, Glenohumeral joint instability, various types of arthritis, and the list goes on. Therefore, it is not easy to develop a diagnosis unless you see an orthopedic/shoulder specialist and/or have an x-ray/MRI performed.

The first thing to know about treating bursitis (and most other inflammatory shoulder problems) is to identify and decrease the movements, positions and activities that exacerbate your symptoms. For example, you may need to stop sleeping on your right side for a few weeks-months. Or you may need to modify the position of your computer mouse. You may need to eliminate certain shoulder exercises in your workout routines. Switch your purse to the opposite shoulder or clean it out to make it lighter. Listen to your body in order to find out what aggravates your pain; then modify those things in order to function with less pain. This is called POSITIONAL AVOIDANCE.

Secondly, you may need MEDICATION. Consult your physician, who will likely prescribe an anti-inflammatory medicine. Your primary care physician will refer you as needed for imaging tests and/or specialist visits. It is important to comply with doctors' orders in order to know if the prescribed treatments are effective.

Any of your doctors (primary or specialist) may refer you for PHYSICAL THERAPY (or Occupational Therapy) if indicated.  Physical Therapy for your shoulder may include exercises, hands-on techniques, pain-relieving modalities, education, postural corrections and other interventions aimed at decreasing your pain and restoring full function of your shoulder.

ICE can also be an effective adjunct to your symptom-management routine. Put a bag of ice or frozen veggies in a T-shirt or pillowcase placed over the location of your pain. Do this for 10-15 minutes, >2x/day.

POSTURE plays a bigger role in shoulder pain that you may realize, so check this area to see how you measure up. Do you slump whenever you sit? What is your posture while working? Is there a posture you stay in for a long period of time each day that aggravates your shoulder pain? Upright posture places all your joints in proper alignment and maximizes their mobility. Try to avoid having your shoulders rounded forward. Sit or stand up tall, with your shoulders back (they should be lined up vertically with your ears).

Lastly, work to improve your BODY MECHANICS during all daily tasks. You should have an ergonomic work station. You may need to modify your computer chair, the placement of your keyboard/mouse, the amount of back support in your recliner chair, your lifting techniques, the placement of heavy objects in your home or garage, etc. The idea of body mechanics is to use your body to its advantage instead of straining your joints by doing difficult tasks incorrectly. Use large muscle groups to do harder work. Use proper lifting and reaching techniques. To prevent shoulder pain, avoid lifting heavy objects overhead. If you are carrying something heavy, hold it with both hands and keep it close to your body. Be sure your shoulders are relaxed (not shrugged up) while you are typing. Turn your thumbs up whenever you reach above shoulder height.

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