Contents
Definition
- Inflammation of the bursa of the shoulder
- One of the most painful pathologies within orthopedics
Causes
- No apparent underlying cause for development
Development
- Quick onset
- Without treatment it is usually dissolved within 6 weeks
Indications
- Even slight movement of the shoulder is incredibly painful
- High amount nighttime pain causing problems with sleep
- This can also be apparent when looking at the patient’s face
- Also pain at rest
- Patient keeps the arm close to the body, not willing to move it as it will provoke pain
Development
- Day 1-3
- At onset the pain increases swiftly to it’s maximum within 3 days
- After 3 days the pain is severe radiating to the entire c5 dermatome
- At onset the pain increases swiftly to it’s maximum within 3 days
- Day 7-10
- Pain starts to decrease after 7-10 days
- Week 2-6
- The last 3-4 weeks the feeling is more of an ache than severe pain
- Week 4-6
- The pain will disappear completely usually after 4-6 weeks, and range of motion returns to normal
- During the end of the period a painful arc may be found again
- The pain will disappear completely usually after 4-6 weeks, and range of motion returns to normal
Examination
- Difficult to perform as the patient is unwilling to move the arm
- Active and passive elevation almost impossible
- Clear limitation of passive abduction
- Other passive movements also painful, but in some cases only barely limited
- Also pain during resisted movements, especially:
- Isometric abduction
- Isometric lateral rotation
- At early stage (first days), painful arc may be present
- Palpation of the upper arm and the superficial part of the bursa is painful and sometimes swollen