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M75.5 – Subacromial Bursitis: Causes & Treatment
M75.5 is the ICD-10 code for subacromial bursitis, an inflammation of the bursa beneath the shoulder roof. It causes shoulder pain and limited range of motion.
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M75.5 is the ICD-10 code for subacromial bursitis, an inflammation of the bursa beneath the shoulder roof. It causes shoulder pain and limited range of motion.
What is M75.5 – Subacromial Bursitis?
The ICD-10 code M75.5 refers to subacromial bursitis, an inflammation of the bursa subacromialis – a small fluid-filled sac located beneath the acromion (the bony roof of the shoulder). This bursa normally acts as a cushion between the rotator cuff tendons and the overlying bone. When inflamed, it swells and causes pain and restricted shoulder movement. Subacromial bursitis is one of the most common causes of shoulder pain in adults.
Causes
The condition can develop due to various factors:
- Overuse: Repetitive overhead movements in sports (e.g., swimming, tennis) or occupational activities (e.g., painters, construction workers).
- Impingement syndrome: Narrowing of the subacromial space due to anatomical variants or degenerative changes.
- Trauma: Falls onto the shoulder or direct impacts.
- Calcific deposits: Calcium deposits near the bursa can cause irritation and inflammation.
- Systemic diseases: Conditions such as rheumatoid arthritis or gout can affect the bursa.
- Degenerative changes: Age-related wear and tear of shoulder structures.
Symptoms
Common signs of subacromial bursitis include:
- Pain on the outer or upper side of the shoulder, often radiating into the upper arm.
- Increased pain with overhead movements – known as the painful arc (typically between 60° and 120° of arm elevation).
- Night pain, especially when lying on the affected side.
- Localized swelling and occasional warmth over the shoulder.
- Reduced range of motion, particularly with lifting and rotating the arm.
Diagnosis
Diagnosis is based on a combination of:
- Medical history: Assessment of pain onset, character, and triggering activities.
- Physical examination: Specific provocation tests such as the Neer test and the Hawkins-Kennedy test help identify subacromial impingement and bursitis.
- Imaging: Ultrasound can reveal bursal thickening and fluid accumulation. X-ray helps exclude bony abnormalities or calcifications. MRI provides detailed information on soft tissue structures and the rotator cuff.
- Differential diagnosis: Other shoulder conditions must be ruled out, including rotator cuff syndrome (M75.1), adhesive capsulitis (M75.0), and calcific tendinitis (M75.3).
Treatment
Conservative Treatment
Most cases of subacromial bursitis respond well to non-surgical management:
- Rest and activity modification: Avoiding pain-triggering movements during the acute phase.
- Cold therapy: Application of ice packs to reduce inflammation and pain.
- Physiotherapy: Targeted exercises to strengthen the rotator cuff and improve shoulder mechanics.
- Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or diclofenac for pain relief and inflammation control.
- Corticosteroid injections: Local injection into the subacromial space for persistent symptoms.
- Extracorporeal shock wave therapy (ESWT): Particularly effective when calcific deposits are present.
Surgical Treatment
If conservative treatment fails after approximately three to six months, surgery may be considered:
- Arthroscopic subacromial decompression: Widening of the subacromial space by removing bone tissue or the inflamed bursa (bursectomy).
Prognosis
The prognosis for subacromial bursitis is generally favorable. With consistent conservative treatment, most patients achieve full recovery. Recurrence is possible if the underlying causes – such as repetitive overhead work or poor posture – are not adequately addressed.
References
- World Health Organization (WHO): ICD-10 Classification of Diseases, Chapter XIII – Diseases of the Musculoskeletal System and Connective Tissue, Code M75.5.
- Koester MC, George MS, Kuhn JE: “Shoulder impingement syndrome”. The American Journal of Medicine, 2005; 118(5): 452–455.
- Brox JI et al.: “Arthroscopic surgery compared with supervised exercises in patients with rotator cuff disease”. BMJ, 1993; 307: 899–903.
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