Shoulder Tendinitis

What is shoulder tendinitis/bursitis?

Shoulder bursitis and tendinitis are common causes of shoulder pain and stiffness. They indicate swelling (inflammation) of a particular area within the shoulder joint.

The shoulder joint is kept stable by a group of muscles called the rotator cuff as well as the biceps tendon. These muscles and tendons keep the upper arm bone (humerus) within the shoulder socket (glenoid). When the rotator cuff tendons or the biceps tendon become inflamed and irritated it is called rotator cuff tendinitis and bicipital tendinitis.

An area called the subacromial bursa lies in the space between the rotator cuff tendons and the part of the shoulder blade bone that hangs over these tendons (the acromion). The bursa is what protects these tendons. Subacromial bursitis occurs when the bursa becomes inflamed.

Both conditions (shoulder bursitis and tendinitis) can cause pain and stiffness around the shoulder and may exist together.

What causes shoulder tendinitis?

Shoulder tendinitis occurs as a result of sports injuries, by repetitive use or overuse of the tendons, or from a sudden, more serious injury. For instance, professional baseball players, swimmers, tennis players, and golfers are susceptible to tendinitis in their shoulders, arms, and elbows. Improper technique in any sport is one of the primary causes of overload on tissues including tendons, which can contribute to tendinitis.

You don’t have to be a professional athlete to develop this condition, however. People with jobs that require overhead work (such as assembly work or an overhead pressing machine) or heavy lifting are at risk of tendinitis, but any person can develop tendonitis from repetitive use of these tendons. A direct blow to the shoulder area or falling on an outstretched arm can also cause shoulder tendinitis.

How is shoulder tendinitis treated?

Treatment goals for shoulder tendinitis include reduction in pain and inflammation, as well as preserving mobility and preventing disability and recurrence. Treatments may include a combination of rest, wrapping, and use of ice packs for recent or severe injuries. Aspirin, naproxen and ibuprofen are used to reduce swelling. Physical therapy, which includes range of motion exercises, is also part of the treatment plan. If pain is constant and severe enough, a cortisone injection can also be given into the shoulder to relieve symptoms.

Surgery is considered if the rotator cuff or biceps tendon has been partially or completely torn and the symptoms do not improve with other treatments. Surgery repairs the damaged tendon or tendons and removes inflamed bursae that may also be irritating the shoulder.

How can shoulder tendinitis be prevented?

Because most cases of shoulder tendinitis are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause the problem. Underlying conditions, such as improper posture or poor technique in sports or work, must be corrected.

Apply these basic rules when performing activities:

• Take it slow at first and gradually build up your activity level.
• Use limited force and limited repetitions.
• Stop if unusual pain occurs.

When should I call my doctor about shoulder tendinitis?

Most cases of shoulder tendinitis go away on their own over time. It may take weeks to months to recover, depending on the severity. See your doctor if you experience pain that interferes with your normal day-to-day activities or have soreness that doesn't improve despite self-care measures. Other reasons to see your doctor are if you have recurrence, or if you have a fever and the area affected by tendinitis appears red or inflamed (swollen, warm). These signs and symptoms may indicate that you have an infection.

In addition, see your doctor if you have other medical conditions that may increase your risk of an infection, or if you take medications that increase your risk of infection, such as corticosteroids or immunosuppressants.