Shoulder

Impingement and bursitis

Painful pinching of the cuff and bursa under the acromion.

What it is

The rotator cuff runs through a narrow space beneath the acromion, cushioned by a bursa. If the bursa becomes inflamed or the space is tight, lifting the arm pinches the tissue and hurts, typically in a painful arc partway up.

How it usually presents

  • Pain lifting the arm between roughly 60 and 120 degrees
  • Discomfort reaching into a cupboard or the back seat of a car
  • Pain lying on the affected side

How it is assessed

Examination with specific impingement tests, and imaging where the diagnosis is unclear or symptoms persist.

Treatment options

  • Physiotherapy focused on posture and shoulder blade control
  • Anti-inflammatory measures and activity modification
  • Guided subacromial injection
  • Arthroscopic decompression in resistant cases

Non-surgical treatment is considered first wherever it is reasonable. Which option suits you depends on your symptoms, your goals and what you want from treatment, which is exactly what we discuss in clinic.

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