What is the treatment for bursitis of the right shoulder?

From the Guidelines

To address bursitis in the right shoulder, start with rest and activity modification by avoiding movements that worsen pain for 1-2 weeks, and consider taking over-the-counter NSAIDs like ibuprofen or naproxen for pain and inflammation, as recommended by recent guidelines 1. When managing bursitis, it's essential to categorize musculoskeletal symptoms and focus on nonpharmacological approaches initially, such as physical therapy, heat/cold, and orthotics 1. Some key considerations for treatment include:

• Avoiding movements that worsen pain for 1-2 weeks
• Applying ice to the affected area for 15-20 minutes several times daily to reduce inflammation
• Taking over-the-counter NSAIDs like ibuprofen (400-600mg three times daily with food) or naproxen (220-440mg twice daily) for pain and inflammation, but limiting use to 7-10 days
• Gentle stretching and range-of-motion exercises to maintain mobility once acute pain subsides For persistent symptoms, it's crucial to see a healthcare provider who may recommend physical therapy, corticosteroid injections, or aspiration of the bursa in severe cases, as suggested by the Canadian stroke best practice recommendations 1. Proper posture and ergonomics during daily activities can help prevent recurrence, and most cases improve within a few weeks with conservative treatment, but chronic or severe cases require medical evaluation.

From the FDA Drug Label

Management of Pain, Primary Dysmenorrhea, and Acute Tendonitis and Bursitis Because the sodium salt of naproxen is more rapidly absorbed, naproxen sodium is recommended for the management of acute painful conditions when prompt onset of pain relief is desired. Naproxen may also be used The recommended starting dose of naproxen is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. The initial total daily dose should not exceed 1250 mg of naproxen. Thereafter, the total daily dose should not exceed 1000 mg of naproxen.

To address bursitis to the right shoulder, naproxen may be used. The recommended starting dose is 500 mg, followed by 500 mg every 12 hours or 250 mg every 6 to 8 hours as required. The initial total daily dose should not exceed 1250 mg of naproxen, and thereafter, the total daily dose should not exceed 1000 mg of naproxen 2.

From the Research

Addressing Bursitis in the Right Shoulder

To address bursitis in the right shoulder, the following steps can be taken:

• Identify the cause of the bursitis, which can be due to various factors such as repetitive overhead activity, trauma, or inflammation 3, 4
• Determine the type of bursitis, such as subacromial bursitis, which is a common cause of shoulder pain 3, 5
• Use conservative management techniques, including:
  • Ice and activity modification to reduce inflammation and pain 6
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce pain and inflammation 6, 5
  • Physical therapy to improve range of motion and strength 3, 5
  • Injection therapies, such as corticosteroid injections, to reduce inflammation and pain 6, 3
• Consider imaging studies, such as magnetic resonance imaging (MRI) or ultrasonography, to evaluate for soft tissue pathology and rule out other conditions 3, 4
• If conservative management is not effective, surgical intervention may be necessary to address underlying conditions such as rotator cuff tears or other structural problems 3, 4

Diagnostic Evaluation

A thorough diagnostic evaluation is essential to determine the cause of bursitis in the right shoulder. This can include:

• Physical examination tests, such as the External Rotation Lag Sign at 90 Degrees and the Internal Rotation Lag Sign, which have high to moderate diagnostic accuracy for ruling in tears of the rotator cuff 7
• Imaging studies, such as X-ray, ultrasound, and MRI, to evaluate for soft tissue pathology and rule out other conditions 3, 4
• A thorough history and physical examination to identify underlying conditions and rule out other causes of shoulder pain 5, 4

Treatment Options

Treatment options for bursitis in the right shoulder depend on the underlying cause and severity of the condition. These can include:

• Conservative management techniques, such as physical therapy, NSAIDs, and injection therapies 6, 3, 5
• Surgical intervention, such as rotator cuff repair or bursectomy, to address underlying structural problems 3, 4
• A combination of conservative and surgical management techniques, depending on the individual case and severity of the condition 3, 4