What Does Surgery for Shoulder Bursitis Include?

Shoulder bursitis is a common yet troublesome condition that can turn even the simplest of daily activities into a painful ordeal. Many sufferers find themselves constantly grappling with nagging shoulder pain and restricted movement, despite trying various non-surgical remedies. When these conservative approaches fall short, the spotlight shifts to surgical interventions.

Shoulder bursitis, how does it develop? When does it reach the point that surgery is needed? Let’s explore this with Fivali! In the following sections, we’ll peel back the layers and carefully examine the different surgical procedures, their benefits, and what patients should be aware of after surgery.

Symptoms of Shoulder Bursitis

The symptoms of shoulder bursitis mainly involve shoulder pain, limited movement, and inflammatory reactions.

• Shoulder Pain

Shoulder pain is a prominent symptom, usually manifesting as a dull ache, sharp pain or persistent throbbing in the shoulder area. It may start mild but worsen over time and gets aggravated when the shoulder moves, such as when reaching or combing hair. Moreover, it can be more acute at night, interfering with sleep.

• Limited Movement

Limited movement is another common manifestation. Patients may find it difficult to perform normal shoulder motions smoothly. Raising the arm above the head becomes a struggle, and there could be a significant reduction in the range of abduction and rotation as well. When trying to put on a coat or do any activity that requires a wide range of shoulder movements, they will notice the restriction clearly.

• Inflammatory Reactions

Inflammatory reactions are evident, with swelling around the shoulder joint making it look puffy and tender. The affected skin may turn redder, showing increased blood flow. There's also warmth compared to surrounding tissues. Tenderness is common, and light pressure on the shoulder can cause pain. Sometimes, when the shoulder is moved, creaking or grating sounds may occur due to the impact of inflammation on tissue movement and interaction within the joint.

When Surgery is Needed for Shoulder Bursitis? 

• Persistent Pain Despite Conservative Treatment

When conservative methods like rest, medications, and physical therapy are tried for a while but the shoulder pain remains severe and persistent. If it continues to disrupt daily life and normal activities for months, say constantly hurting during simple movements like reaching or lifting, surgery might be considered to relieve the agony.

• Recurrent Bursal Effusion

If there's repeated fluid buildup in the bursa even after multiple aspirations. For example, when the swelling keeps coming back after draining the fluid, causing ongoing pain and restricted movement each time. When non-surgical means can't stop this recurrence, surgical treatment may be needed to address the root cause of the effusion.

• Impaired Shoulder Function

When the bursitis leads to significant limitation in shoulder movements that affects work or personal life. Such as being unable to raise the arm properly to perform tasks like hanging clothes or driving for a long time. If rehabilitation efforts don't improve the function, surgery could be an option to restore normal mobility.

Types of Surgery for Shoulder Bursitis

The following are common types of surgeries for shoulder bursitis:

Bursectomy: This is one of the main surgical approaches. In a bursectomy, the surgeon removes the inflamed bursa completely. It is usually considered when the bursa is severely damaged or when conservative treatments have failed to relieve the inflammation and associated symptoms. By taking out the affected bursa, the source of irritation and pain caused by the inflamed tissue can be eliminated.

Arthroscopic Surgery: With the help of arthroscopic techniques, the surgeon can access the shoulder joint through small incisions. Through the arthroscope, the doctor can clearly visualize the inside of the joint and the bursa. This type of surgery allows for precise removal of damaged tissue, drainage of any fluid accumulation in the bursa, and treatment of any associated joint problems.

Debridement: Debridement involves cleaning up the damaged and inflamed tissues within the bursa. The surgeon carefully removes any debris, scar tissue, or dead cells from the area. This helps to reduce inflammation and promote the healing process. It is often combined with other procedures when dealing with chronic shoulder bursitis to improve the condition of the bursa and relieve pain and limited movement.

Postoperative Rehabilitation for Shoulder Bursitis

I Initial Stage (1 - 2 weeks after surgery)

• Immobilization and Rest: The shoulder should be kept relatively fixed. Wearing a doctor-advised shoulder bursitis brace is essential as it helps maintain the proper shoulder position and aids surgical wound healing. For instance, when sleeping, keep the shoulder in the right position to avoid pressure on the wound.
• Gentle Mobility Exercises: Under the doctor's permission, begin with gentle finger, wrist and elbow movements like making fists, etc. Do them 10 - 15 times each time, repeating 3 - 4 sets daily. It can promote blood circulation and prevent issues like blood clots in limbs or muscle atrophy.

II Intermediate Stage (3 - 6 weeks after surgery) 

• Increasing Range of Motion Exercises: Gradually conduct passive shoulder movements with a rehabilitation therapist's help, including forward flexion, backward extension and abduction. Increase the range of motion gradually. Do these 10 - 15 minutes each time, 2 - 3 times a day to prevent adhesion and restore joint function.
• Muscle Strength Training Initiation: Simple isometric contraction training can be conducted. For example, perform static contractions of the deltoid muscle, supraspinatus muscle, etc. Hold the contraction for 3 - 5 seconds and then relax. Repeat 10 - 15 times as a group and do 3 - 4 groups a day. This helps maintain muscle strength and prepares for further rehabilitation.

III Advanced Stage (7 weeks after surgery and onwards)

• Enhancing Active Movements: The patient should do comprehensive active shoulder joint exercises like internal and external rotation, elevation. Increase the activity's difficulty and intensity, for example, with a light dumbbell. Do it 20 - 30 minutes each time, 2 - 3 times a day to restore normal range and flexibility.
• Improving Strength and Endurance: Conduct more challenging strength training, like using elastic bands for shoulder abduction and adduction, doing 15 - 20 reps per group, 3 - 4 groups daily. Combine with functional training simulating daily actions to improve shoulder muscle strength and endurance for daily needs.

Precautions 

1. Follow Doctor's Instructions 

Strictly follow the doctor's rehabilitation plan and medication guidance. Have regular follow-ups as the doctor will adjust the program based on recovery. Don't alter medication dosage or training content on your own to prevent affecting rehabilitation or causing surgical area issues.

2. Donning Shoulder Brace

After shoulder bursitis surgery, wearing a shoulder brace for bursitis is of great importance. It stabilizes the shoulder joint, reducing the risk of displacement during movements and ensuring proper tissue healing. The shoulder brace lessens pain by evenly distributing pressure and minimizing strain on the surgical site. Moreover, it promotes healing by creating a favorable environment for tissue repair. It also prevents re-injury as it restricts harmful movements. Additionally, it aids in rehabilitation exercises, making them safer and more effective.

Fivali Shoulder Sling Immobilizer is designed for the treatment of rotator cuff tears and dislocations, preventing strains and dislocations to aid in injury recovery. The removable strap and armpit pillow relieve pressure, providing maximum stability and support for your arm and shoulder. 3 tension straps adjustment and multiple Velcro design ensure the best fit. Breathable and soft material is suitable for long-term comfortable fixation.

Overall, the Fivali bursitis shoulder brace plays a crucial role in a smooth recovery process.

3. Diet Adjustment

Ensure a balanced diet. Have more protein-rich foods like lean meat, fish, etc. for wound healing and muscle repair. Also, eat more fruits and veggies rich in vitamins and minerals to boost immunity. Meanwhile, reduce spicy, greasy and irritating foods to avoid discomfort and aid recovery.

Surgery for shoulder bursitis is an effective treatment, but it is not suitable for all patients. Before surgery, patients should fully communicate with their doctors to understand the risks and benefits of the surgery and be fully prepared psychologically. After the surgery, patients should actively cooperate with the doctor's treatment, apply appropriate shoulder and bicep compression sleeve and review on time in order to achieve better recovery results.