Bursitis in Shoulder
What is shoulder bursitis?
Shoulder bursitis is the result of inflammation in the bursa. The bursae (bur-SEE) are potential fluid-filled sacs that are part of the skeletal system. They cushion the space between bones and connective tissue, allowing tendons, muscle and bone to move together.
In the shoulder, the subacromial bursae cushion the area between the rotator cuff tendons and the acromion (the highest point of the shoulder blade or scapula). Bursae allow the tendons and bones to glide without friction when you move and lift your arms.
Injuries or overuse can cause fluid to collect in bursae, causing bursitis. Painful swelling may come on gradually or suddenly. Healthcare providers may use the medical term subacromial bursitis or rotator cuff tendinitis to refer to bursitis that affects the shoulder.
What are the types of shoulder bursitis?
The different types of shoulder bursitis include:
- Chronic: Repeat injuries or repeated incidents of acute bursitis can cause chronic shoulder bursitis. It’s the most common type of shoulder bursitis. You may have periods without symptoms and then have symptom flare-ups (return of symptoms) that last several months. Over time, this ongoing inflammation can cause arm and shoulder weakness. Many people learn how to adapt to the pain (term accommodation). This may lead to other regional pain (think different area of the shoulder, neck or elbow pain).
- Acute: This type comes on suddenly, often from an accident or injury. Touching or moving the shoulder causes pain.
- Infectious (septic): In rare cases, bacterial infections like staph infections cause infectious (septic) shoulder bursitis. The shoulder may look red or purple and feel warm to the touch. In this rare case, you may have a fever and feel sick. You may have severe shoulder pain.
Symptoms and Causes
What causes shoulder bursitis?
Bursitis most commonly affects the shoulder, but it can develop in any joint. Shoulder bursitis is often the result of overuse or repetitive shoulder movements.
Overhead activities increase friction between bones and tissues. This ongoing friction can inflame and irritate bursae. When fluid builds up in the bursa sacs, you have bursitis.
What are the risk factors for shoulder bursitis?
Anyone can get shoulder bursitis. Certain professionals and athletes who do a lot of repetitive shoulder movements are more prone to this problem. These include painters, carpenters and builders, and people who play football, softball or lacrosse.
You may be more prone to shoulder bursitis if you have:
- Arthritis or gout.
- Kidney disease or uremia (waste buildup in blood).
- Rheumatoid arthritis.
- Thyroid disease.
What are the symptoms of shoulder bursitis?
Shoulder pain from bursitis can come on suddenly or gradually. You may experience a dull ache, sharp pain or mild tenderness.
Other signs of shoulder bursitis include:
- Shoulder stiffness or a feeling of swelling.
- Painful range of motion.
- Nighttime pain when lying on the affected side.
- Sharp or pinching pain with overhead shoulder motions.
What other conditions cause shoulder pain?
Most people who get shoulder bursitis also have shoulder tendinitis (damage to rotator cuff tendons). Both conditions cause shoulder pain, inflammation and stiffness.
These conditions can also affect shoulder mobility and cause shoulder pain:
- Bone spurs or calcific tendinitis.
- Dislocated shoulder.
- Frozen shoulder.
- Rotator cuff tears.
- Shoulder impingement syndrome.
Diagnosis and Tests
How is shoulder bursitis diagnosed?
Your healthcare provider will perform a physical exam to assess shoulder pain and range of motion. You may also get these diagnostic tests:
- X-rays to check for arthritis, bone spurs and other problems that can affect the shoulder.
- MRI or ultrasound to look for inflammation in bursae.
- Joint aspiration to drain and test fluid in the bursa for infection or gout.
Management and Treatment
How can I treat bursitis at home?
You can use certain methods to relieve bursitis symptoms. Here’s how to treat shoulder bursitis at home:
- Temporarily stopping activities that aggravate the shoulder.
- Ice packs to reduce inflammation.
- Pain relievers and nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain and swelling.
What are nonsurgical treatments for shoulder bursitis?
Treatments for shoulder bursitis focus on reducing inflammation and minimizing symptoms. Most people get symptom relief with these nonsurgical treatments:
- Bursa (steroid) injections to ease pain and swelling for a couple of months.
- Corticosteroids, such as Kenalog or Celestone that you take orally for severe pain and inflammation.
- Physical therapy exercises to strengthen weak muscles and improve range of motion.
- Antibiotics to clear up bacterial infections that cause bursitis.
What are surgical treatments for shoulder bursitis?
If symptoms get worse or don’t improve with nonsurgical treatments, your healthcare provider may recommend surgery. This surgery may take place arthroscopically using small incisions and a tiny camera (arthroscope).
Your provider may remove:
- Damaged tissue that presses on and irritates the bursae.
- Inflamed bursae to make room for the tendons and bones to move.
How can I prevent shoulder bursitis?
These steps may reduce your risk of shoulder bursitis:
- Do shoulder stretching and strengthening exercises regularly.
- Warm up the shoulder before doing activities.
- Take breaks during repetitive activities.
- Wear a shoulder brace to ease stress on the shoulder.
Outlook / Prognosis
What are the complications of shoulder bursitis?
Chronic shoulder bursitis and repeated flare-ups can damage the bursae. Over time, this may affect shoulder mobility.
Bacteria that cause infectious (septic) shoulder bursitis can spread to organs and other parts of the body. In severe cases, sepsis can be life-threatening.
What is the prognosis (outlook) for people with shoulder bursitis?
Most people with shoulder bursitis get symptom relief without surgery. But chronic shoulder bursitis often comes back. It’s important to give your body time to rest and heal. Some people who have severe shoulder pain need surgery.
When should I call the doctor about shoulder pain or shoulder bursitis?
You should call your healthcare provider if you experience:
- Pain or limited range of motion in the shoulder or arm that interferes with daily life.
- Pain that doesn’t improve with at-home treatments.
- Shoulder or arm weakness.
- Signs of infection, such as fever and chills.
- Unusual redness or swelling in the shoulder.
What questions should I ask my doctor about shoulder bursitis?
You may want to ask your healthcare provider:
- What caused shoulder bursitis?
- What treatments can help?
- Can physical therapy or other exercises help?
- Would I benefit from surgery?
- How can I prevent future shoulder problems?
- Should I look out for signs of complications?
A note from Cleveland Clinic
Shoulder bursitis is a painful inflammatory condition. It can limit the range of motion in your shoulder and arm. Most people get symptom relief through nonsurgical therapies. Rest, wearing a brace and performing physical therapy exercises can be useful. Your healthcare provider can help you manage symptoms and prevent future episodes of bursitis.
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