Shoulder Bursitis

By Sally Ann Quirke, Chartered Physiotherapist | Filed under: Shoulder Pain, Bursitis

Published: 27 November 2015

Bursitis in the Shoulder

An introduction

Shoulder bursitis occurs when there is inflammation of a bursa around your shoulder. It is a common enough condition, but is often misdiagnosed. You need to be careful with diagnosis as it can often be confused with an inflammation of the rotator cuff injury, which is an inflammation of a group of tendons around the shoulder joint.

The shoulder bursa is called the sub-acromial bursa. It separates the supraspinatus tendon which is one of the rotator cuff tendons from the acromion bone. It acts like a cushion between the tendons and the bone. The shoulder is a complex joint which involves many bones, muscles and ligaments which connect the arm to the chest. The main shoulder bursa lies between the humerus (upper arm bone) and the acromion (top of the shoulder blade).

In between these bones lie tendons and when the bursa gets impinged between these bones bursitis often results. Normally, the tendons and bursa slide effortlessly between both these bones. If the space becomes too narrow as a result of arthritis or movement problems tendonitis or bursitis may result. Inflammation results in thickening of the bursa in this case, which results in too much compression on the bursa resulting in further inflammation and pain.

Other causes of shoulder bursitis

Shoulder bursitis can also result from rheumatoid arthritis and gout, but it is more commonly due to movement problems in the shoulder and shoulder girdle. Although the pain associated with shoulder bursitis is usually sudden in onset, the underlying cause has usually been there for some time.

I like to compare it to a tight pair of jeans. You can wear your tight jeans for weeks and then one day they rip! The rip was due to all the days of wearing them and not just the one specific day that they ripped! It was just the final straw that broke the camel’’s back! Bursitis is often the same.

Commonly, shoulder bursitis is secondary to a ‘creaky’, and achy shoulder. It can also arise in conjunction with tendonitis or impingement. This is very painful! Do not ignore the small stuff. Prevention is better than cure!

Treatment of shoulder bursitis involves treating the bursitis and subsequently the cause of the bursitis. Treating the bursitis involves, ice, rest, anti-inflammatory medication, and in more severe cases cortisone injections and further medical intervention.

Getting rid of the cause involves Physiotherapy that addresses the movement problem that you have through mobilisation and exercises. If overuse of your arm is the cause the way you work will have to be assessed and advised on altering movement patterns. A physiotherapist specialising in ergonomics will advise you well. Attention to posture and exercises are a must!!

If an infection is present, caught early it usually responds to antibiotics and the above conservative treatment. If left too long surgery may be required. This surgery is known as a bursectomy. This is where the bursa is removed and usually grows back in some form or another!! Surgery is the last option in my opinion. Exhaust all conservative treatments first.