SHOULDER-BLADE (SCAPULA) BURSITIS
DEFINITION--Inflammation of any of the bursas of the scapula (shoulder blade or wingbone). Bursitis may vary in degree from mild irritation to an abscess formation that causes excruciating pain. There are several bursas around the body of the scapula. Scapula bursitis develops most frequently in the bursa between the body of the scapula and muscles of the chest wall.
BODY PARTS INVOLVED
Scapula bursas (soft sacs filled with lubricating fluid that facilitate motion in the scapula area).
Soft tissue surrounding the scapula, including nerves, tendons, ligaments, large blood vessels, capillaries, periosteum (the outside lining of bone) and muscles.
SIGNS & SYMPTOMS
Pain around or under the scapula.
Redness (sometimes) over the affected bursa.
Fever if infection is present.
Limitation of motion in the scapula area, including the shoulder.
Injury to the scapula.
Acute or chronic infection.
RISK INCREASES WITH
Participation in competitive athletics, particularly contact sports such as football.
Previous history of bursitis in any joint.
Exposure to cold weather.
Poor conditioning and inadequate warmup.
Inadequate protective equipment in contact sports.
HOW TO PREVENT
Use protective gear for contact sports.
Warm up adequately before athletic practice or competition.
Wear warm clothing in cold weather.
To prevent recurrence, continue to wear extra protection over the scapula until healing is complete.
WHAT TO EXPECT
APPROPRIATE HEALTH CARE
Doctor's diagnosis and treatment.
Surgery (sometimes), particularly for a frozen joint.
Your own observation of symptoms.
Medical history and physical exam by a doctor.
X-rays of the shoulder and scapula.
Frozen scapula, with temporary or permanent limitation of the normal mobility of both scapula and shoulder.
Prolonged healing time if activity is resumed too soon.
Proneness to repeated flare-ups.
Unstable or arthritic scapula following repeated episodes of bursitis.
Spontaneous rupture of bursa if severe infection is present.
PROBABLE OUTCOMEScapula bursitis is a common problem. Symptoms usually subside in 7 to 14 days with treatment. Chronic bursitis may require 6 to 8 months to heal.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
FIRST AIDNone. This problem develops slowly.
Use ice massage. Fill a large Styrofoam cup with water and freeze. Tear a small amount of foam from the top so ice protrudes. Massage firmly over the injured area in a circle about the size of a softball. Do this for 15 minutes at a time, 3 or 4 times a day, and before workouts or competition.
After 72 hours of ice treatment, apply heat if it feels better. Use heat lamps, hot soaks, hot showers, heating pads, or heat liniments or ointments.
Use a sling to support the shoulder and scapula, if needed.
Elevate the inflamed scapula and shoulder above the level of the heart to reduce swelling and prevent accumulation of fluid. Use pillows for propping.
Gentle massage will frequently provide comfort and decrease swelling.
MEDICATIONYour doctor may prescribe:
Non-steroidal anti-inflammatory drugs.
Prescription pain relievers for severe pain. Use non-prescription aspirin, acetaminophen or ibuprofen (available under many trade names) for mild pain.
Injections into the inflamed bursa of a long-lasting local anesthetic mixed with a corticosteroid drug, such as triamcinolone.
ACTIVITYRest the inflamed area as much as possible. If you must resume normal activity immediately, use a sling to immobilize the shoulder and scapula and help reduce pain. To prevent a frozen shoulder, begin normal, slow joint movement as soon as possible.
DIETEat a well-balanced diet that includes extra protein, such as meat, fish, poultry, cheese, milk and eggs. Increase fiber and fluid intake to prevent constipation that may result from decreased activity. Your doctor may suggest vitamin and mineral supplements to promote healing.
REHABILITATIONSee section on rehabilitation exercises.
CALL YOUR DOCTOR IF
You have symptoms of scapula bursitis.
Pain increases despite treatment.
Pain, swelling, tenderness, drainage or bleeding increases in the surgical area.
You develop signs of infection (headache, muscle aches, dizziness or a general ill feeling and fever).
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.