From the Guidelines
Bursitis of the shoulder typically presents with pain, swelling, and limited range of motion in the affected shoulder, and treatment should focus on nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics, before considering pharmacological treatments 1. The symptoms of bursitis of the shoulder can be categorized into several key areas, including:
- Pain, which is often localized to the top or outer side of the shoulder and worsens with movement or pressure
- Swelling and limited range of motion in the affected shoulder
- Redness, warmth, and tenderness around the shoulder joint
- A grinding or popping sensation with movement of the shoulder
- Increased pain at night, especially when lying on the affected shoulder
- Muscle weakness in chronic cases due to disuse
According to the American Heart Association, initial treatment should focus on nonpharmacological approaches, such as physical therapy, heat/cold, and orthotics 1. When pharmacological treatments are considered, the least risky medication should be tried first, with escalation only if the first medication is ineffective 1. In terms of diagnostic imaging, MRI and ultrasound are equivalent in evaluating questionable bursitis or long head of biceps tenosynovitis, with a rating of 9 on the appropriateness criteria 1. The most appropriate treatment approach for bursitis of the shoulder is to start with nonpharmacological methods and progress to pharmacological treatments only if necessary, while also considering diagnostic imaging options like MRI or ultrasound if needed 1.
From the Research
Symptoms of Bursitis of the Shoulder
The symptoms of bursitis of the shoulder are not directly described in the provided studies. However, the studies discuss the treatment of shoulder pain, which can be related to bursitis.
Treatment of Shoulder Pain
- Corticosteroid injections are commonly used to treat musculoskeletal conditions, including shoulder pain 2.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are also used to treat shoulder pain, but they may be less effective than corticosteroid injections in achieving remission 3.
- The efficacy of nimesulide and naproxen sodium in treating tendinitis and bursitis has been compared in a double-blind parallel trial, showing similar improvement in pain and functional impairment 4.
Adverse Events
- Adverse events related to corticosteroid injections include an increase in blood glucose, adrenal suppression, detrimental effect on cartilage lining the joint, reduction of bone mineral density, and postoperative joint infection 2.
- Side effects of NSAIDs, such as nimesulide and naproxen sodium, are mainly gastrointestinal 4.