Man with shoulder pain
June 20, 2018 | by Daniel Schwartz MD

What is Shoulder Bursitis?

Shoulder bursitis refers to inflammation of the shoulder bursa. Bursa are small, fluid-filled sacs that help cushion movement and prevent friction in the joints. Bursa contain a lubricating substance called synovial fluid, which aids in the cushioning effect. They are usually present in areas subject to movement, such as between the bones, tendons and muscles near the joints.

The shoulder contains a large amount of bursa as it is one of the largest joints in the body—and the reason why it is the area most commonly affected by bursitis. Symptoms of shoulder bursitis usually include tenderness, pain, heat, and swelling. Movement may be limited due to stiffness. Pain is often worse in the morning or after physical activity.

Shoulder pain may also be caused by subacromial bursitis, which can occur when shoulder bursa are trapped and compressed between your rotator cuff tendons and bone (acromion) during shoulder movements.

Causes of Shoulder Bursitis

Bursitis is often caused by strenuous or repetitive activity such as throwing, lifting, or digging. Sports such as baseball, football, and basketball have high incidences of shoulder bursitis.

In other cases, a single injury or trauma to the shoulder can result in bursitis, particularly falls or collisions.

Inflammatory conditions such as rheumatoid arthritis or systemic lupus erythematosus may also lead to irritation of the shoulder joint and subsequent bursitis. Bursitis may also occur for no apparent reason.

Prevention

Reducing the risk and severity of shoulder bursitis can be as simple as changing a few lifestyle routines. Patients should avoid carrying heavy loads where possible, and take frequent breaks from repetitive activities that involve the shoulder, such as digging or painting.

Exercises that strengthen the surrounding muscles in the shoulder are also advised. Warming up the shoulder before physical activity also helps to reduce trauma to the area. Stretching the shoulder and arm muscles after physical activity can ease muscle strain and reduce inflammation.

Treatment

Treatment of shoulder pain should not be delayed. When left untreated, shoulder bursitis can lead to calcium deposits building up in the soft tissues, known as calcific bursitis. This may permanently limit or inhibit movement of the shoulder.

Shoulder bursitis treatment usually begins with reducing the inflammation. This may be done by applying ice compresses to relieve swelling. Rest is also advised. You may be fitted with shoulder sling to support the joint and prevent movement. Your doctor will usually prescribe pain relief medication.

Severe bursitis may require fluid to be removed manually from shoulder bursa to relieve pressure. This treatment is known as aspiration, and is done with a needle and syringe. Shoulder surgeons can also help identify proper treatment. A shoulder bursitis treatment program usually involves some form of physiotherapy to help restore movement in the shoulder muscles. Alternative therapies such as acupuncture may be recommended for helping to relieve pain.

If necessary, corticosteroid injections can help to reduce inflammation and improve mobility. Surgical removal of the damaged bursa is rarely necessary, but may be advised if bursitis is both severe and chronic.

To schedule an appointment with Dr. Daniel Schwartz, please contact his office at 206.860.5578.

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Written By: Daniel Schwartz MD