What is Bursitis of the Shoulder?

Shoulder pain is annoying in daily activities, and the resultant overall discomfort can be very frustrating. One of the most common diagnoses behind this complaint is shoulder bursitis. Bursitis of the shoulder is a common condition that involves pain within the joint, accompanied by remarkable limitations in its movements.

This article discusses the causes and symptoms of shoulder bursitis, methods of diagnosis, and treatment options that will prove valuable in comprehending how to manage this discomfort properly and restore shoulder mobility.

What is Bursitis of the Shoulder?

Bursitis of the shoulder, or impingement syndrome, is the irritation and inflammation of bursae—the tiny sacs filled with fluid that cushions surrounding bones, tendons, and muscles—between a person’s shoulder joint. [1] The bursae help in reducing friction and permitting smooth motion of the shoulder. If the bursae are irritated or inflamed, this may cause shoulder pain or swelling, along with a limited range of shoulder movements.

The shoulder joint is complex, with coordination among bones, tendons, muscles, and bursae to allow a range of movement. However, the repetitive use of the base, overwork, injury, or some medical conditions may cause bursa inflammation, resulting in shoulder bursitis.

Causes of Shoulder Bursitis

Here are some common causes of shoulder bursitis:

• Repetitive Movements: Engaging in repetitive overhead activities or motions, such as lifting or throwing heavy objects, can bring about undue pressure on the shoulder joint over time, eventually causes bursitis of the shoulder. [2]
• Overuse: Overusing the shoulder joint without adequate rest and recovery time can also lead to bursitis.
• Bad Posture: Maintaining a bad posture for a very long time, such as slouching or bending the shoulders forward, increases additional stress on the shoulder joint, leading to inflammation in the bursa.
• Trauma or Injury: Direct damage to the shoulder, such as a fall on the shoulder or sudden impact, can harm the bursa and surrounding tissues. [3]
• Age-related Changes: As one ages, the bursa and associated structures of the shoulder may undergo degenerative changes that render them susceptible to inflammation or even bursitis.
• Pre-existing Conditions: Some medical issues are likely to cause bursitis in the shoulder, such as arthritis, gout, or infection.

Symptoms of Shoulder Bursitis

Here are some common signs to watch out for:

• Persistent shoulder pain, especially with movement. [4]
• Swelling and tenderness around the shoulder joint.
• Limited range of motion in the shoulder.
• Painful movements, particularly overhead.
• Difficulty sleeping due to shoulder discomfort.
• Grinding or some popping sensation in the shoulder joint.
• Radiating pain down the arm or into the neck.

How is Shoulder Bursitis Diagnosed?

Diagnosing shoulder bursitis would typically involve taking a medical history, conducting a physical examination, and diagnostic testing.

• Physical Examination: An extensive physical examination of the shoulder joint will follow, investigating swelling, tenderness, range of motion, and any inflammation or impingement signs.
• X-ray: It shall provide a clear image of the bones and can assist one in identifying any deformities or bone spurs that lead to shoulder pain.
• Ultrasound: High-frequency inaudible sound waves are directed into the joint, and the resultant echoes are used to create real-time images of internal structures in the shoulder. It is often used to visualize the bursa and look for signs of inflammation or fluid build-up.
• Magnetic Resonance Imaging (MRI): The MRI test uses magnets and radio waves in combination to create detailed images of the soft tissues as bursa and surrounding structures. This imaging test establishes if there is any inflammation and other abnormalities in the shoulder joint.
• Laboratory Tests: A fluid sample from the bursa—a sporadic case suspected to be infected—may be collected and further analyzed to confirm an infectious process.

Treating Shoulder Bursitis

The management of shoulder bursitis may include a spectrum of treatments, from home remedies to professional medical interventions to relieve pain and inflammation. Here is how you can manage it:

Home Treatment

• Rest and Avoidance of Overuse: When the affected shoulder is rested and overuse activities that cause pain are minimized, there is a reduction in inflammation within the bursa, and the bursa regenerates.
• Ice therapy: Apply ice packs for 15-20 minutes over the inflamed shoulder several times daily for pain relief. [5]
• Pain Management: Over-the-counter pain relievers, like acetaminophen or ibuprofen, help manage pain and inflammation related to shoulder bursitis.
• Gentle Exercises: A physical therapist can prescribe specific exercises to strengthen the shoulder muscles and improve the range of motion.

Non-Surgical Treatment

• Anti-Inflammatory Medications: Medications like Ibuprofen or Advil can reduce swelling and pain.
• Corticosteroid Injections: In severe cases, these injections may be administered directly into the bursa to lessen inflammation and relieve pain.
• Oral Corticosteroids: In severe cases, oral corticosteroids like Kenalog or Celestone may be prescribed to reduce inflammation.
• Bursa Injections: Steroid injections directly into the bursa can provide relief for several months.

Surgical Treatment

In cases that persist despite conservative treatment, surgery is sometimes required. Arthroscopy is a surgical intervention that enables the removal of the inflamed bursa and, in some cases, bone spurs to create more space for the rotator cuff tendons.

Preventing Shoulder Bursitis

Here are some effective preventive measures to prevent bursitis:

• Maintain good posture to reduce strain on the shoulders.
• Get your body ready for exercise by doing warm-up exercises to prepare the joints and muscles.
• Gradually intensify the level of activity to avoid overuse injuries.
• Use proper techniques during repetitive tasks to prevent shoulder strain.
• Take regular breaks to rest shoulder muscles during repetitive activities.
• Strengthen shoulder muscles with targeted exercises for stability.
• Use protective gear like shoulder pads during sports to prevent injury.

When to Contact Your Healthcare Provider

Here are situations where you should consider contacting your healthcare provider:

• If you experience persistent or worsening shoulder pain.
• If you notice significant swelling, redness, or warmth around the shoulder joint.
• If you have difficulty moving your shoulder or performing daily activities.
• If you develop a fever or experience chills along with shoulder pain.
• If you cannot bear weight on the affected shoulder or experience arm weakness.
• If you experience numbness, tingling, or weakness in the arm or hand.
• If you have a history of shoulder injury and develop new or worsening symptoms.
• If home treatment measures don’t alleviate symptoms or if you have concerns about treatment.

Final Thoughts

Shoulder bursitis can be a painful and limiting condition, but it is possible to alleviate symptoms and improve shoulder health with proper understanding and management. Moreover, incorporating preventive measures into your lifestyle, such as maintaining good posture and avoiding overuse activities, can help reduce the risk of developing shoulder bursitis in the first place.

By taking these steps and staying proactive in managing shoulder health, you can effectively cope with shoulder bursitis and maintain optimal shoulder function for the long term.