How To Move Without Pain

What is Shoulder Bursitis?

by Meghan Griech, PT, DPT, cert MDT, CKTP

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Shoulder bursitis is a painful inflammation that could be a reason for people to feel like they can’t use their shoulder or even move the way they want to.  Shoulder bursitis can occur when the bursae become irritated, inflamed, and swollen.  Bursae are small fluid-filled sac that reduce joint friction and tissue rubbing when the joint structures are moving.  Tendons are able to move smoothly because the bursae provide a smooth surface of movement.   

In the shoulder specifically, there is a bursa that lies between your rotator cuff tendons and the acromion (the body “roof” that creates the top of the shoulder).  This particular bursae, known as the subacromial bursae, allows the rotator cuff tendons to glide smoothly without friction so you can move and lift your arm easily. When the bursa becomes inflamed, normal movements can cause pain because it is sensitive to the tendons that normally rub against it.  This normal function can now create pain and avoid motions.  This subacromial region is one of the most common places to develop bursitis in the shoulder.

Anyone can get bursitis, yet athletes who play football, softball, lacrosse or baseball are more prevalent to develop shoulder pain due to the bursae.  Workers who have jobs where they need to reach overhead repeatedly like painters, carpenters, and builders are also more prone to developing it.

What causes shoulder bursitis?

Inflammation of the shoulder bursae can occur for many reasons. Infection can be a cause, yet more often bursitis is caused by overuse or injury to the bursae. Bursitis can also occur in conjunction with arthritis, gout, or tendonitis. 

Overhead activities can cause constant pressure on the tissues within the shoulder. Repeated pressures can lead to irritation that can progress to inflammation. This inflammation causes a thickening of the tendons and bursae, leading to bursitis. 

What are the symptoms of shoulder bursitis?

  • Pain and soreness on the outer top of the shoulder – the pain can be all of a sudden or gradual
  • Pain can occur at rest
  • Repetitive activity/movements increase the pain
  • Sensitive to pressure, unable to sleep on the shoulder
  • Reaching overhead increases the pain
  • Redness or heat on the top of the shoulder
  • Pushing/pulling a door can be painful and feel difficult
  • Initially, reducing the progression of pain in the shoulder should be the focus. Avoiding activities and positions that produce or increase pain is key. For many patients, a few weeks of these measures will be enough to treat shoulder bursitis.

What can you do to reduce shoulder pain?

  • Ice the shoulder, using a frozen bag of vegetables or a bag of ice.  In some people, ice may be uncomfortable or cause more pain, so if heat feets better, that is also fine.
  • Rest your elbow on arm rest or with pillows to take the weight of the arm  off the shoulder when sitting.
  • Complete shoulder pendulums
  • Avoid movements that  provoke the pain early on.
  • Do move the shoulder in directions and movements that don’t create pain to reduce the chances of shoulder stiffness.
  • Talk to your doctor about medications to reduce the pain. 

How can you prevent shoulder bursitis?

  • Regularly stretches of the shoulder in all directions to maintain mobility 
  • When working overhead take breaks to relieve fatigue and strain
  • Uce ice when the shoulder is painful
  • If pain is beginning, try to change movements temporarily to help reduce  the pain

Shoulders can recover and heal from bursitis without needing surgery. Chronic shoulder bursitis and repeated flare-ups of pain and inflammation can damage the bursae. Repeated cycles of pain and inflammation can cause the shoulder to develop limitations in the range of motion and progressive weakness. Surgery is usually a ‘last resort’ when pain persists for extended periods of time, leading to  progressing limitations in functional activities, like dressing, reaching into cabinets. 

*Disclaimer: All information in this article is intended for instruction and informational purposes. The author(s) are not responsible for any harm or injury that may result.  This information is used to supplement not replace any advice you were provided from your doctor or another medical health professional.  No guarantees of specific results are expressly made or implied with this article.

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