Shoulder Bursitis: A Layperson's Guide
Shoulder bursitis is inflammation of a fluid-filled sac (bursa) that cushions the joint and helps muscles and tendons glide smoothly over bones in your shoulder. This condition causes pain and limits movement in the affected shoulder.
What Is a Bursa?
Bursae are small, fluid-filled sacs that act as cushions between bones, tendons, and muscles around your joints. They reduce friction during movement. The main bursa in the shoulder is called the subacromial-subdeltoid bursa, which sits between the rotator cuff tendons and the bone above them (acromion).
What Causes Shoulder Bursitis?
Several factors can cause shoulder bursitis:
- Repetitive movements - Frequent overhead activities like painting, swimming, or throwing
- Direct trauma - Falls or impacts to the shoulder
- Age-related wear and tear - Natural degeneration over time
- Other conditions - Rotator cuff injuries, calcium deposits in tendons, or arthritis
- Infection - Though less common, bacteria can infect the bursa
Common Symptoms
When you have shoulder bursitis, you might experience:
- Pain on the outside or top of your shoulder
- Pain that worsens with overhead movements
- Tenderness when pressing on the shoulder
- Limited range of motion
- Pain that may radiate down the arm
- Pain that can disturb sleep, especially when lying on the affected shoulder
Diagnosis
Healthcare providers diagnose shoulder bursitis through:
- Physical examination - Testing range of motion and identifying painful movements
- Imaging tests - Ultrasound can effectively visualize the bursa and determine if it's inflamed 1
- X-rays - To rule out other causes like bone spurs or calcium deposits
- MRI - Sometimes needed for more detailed imaging of soft tissues 2
Treatment Options
Treatment for shoulder bursitis typically follows a progressive approach:
Initial Treatment
- Rest and activity modification - Avoiding movements that cause pain
- Ice therapy - Applying cold packs to reduce inflammation 2
- Pain medications - NSAIDs (like ibuprofen) are recommended as first-line treatment 2
Physical Therapy
- Gentle range of motion exercises - To maintain mobility
- Progressive strengthening - Focusing on rotator cuff and shoulder blade muscles
- Scapular stabilization exercises - To improve shoulder mechanics 2
Advanced Treatment
- Corticosteroid injections - For significant pain, though limited to 3-4 per year to avoid tendon weakening 2
- Antibiotics - If infection is present (septic bursitis) 3
- Surgery - Rarely needed, but may be considered for persistent cases not responding to other treatments 4
Recovery Timeline
Most people with shoulder bursitis improve with conservative treatment:
- Initial improvement: 1-2 weeks
- Significant improvement: 6 weeks
- Full recovery: Often within 3 months
If symptoms persist beyond 3 months despite appropriate treatment, further evaluation or specialist referral may be needed 2.
Prevention Tips
To prevent recurrence of shoulder bursitis:
- Avoid repetitive overhead activities when possible
- Take breaks during activities that stress the shoulder
- Maintain good posture
- Strengthen shoulder muscles through appropriate exercises
- Use proper technique during sports and physical activities
Remember that early treatment typically leads to better outcomes and faster recovery from shoulder bursitis.