Shoulder Bursitis

What is shoulder bursitis?

Shoulder bursitis is bursitis that affects your shoulder joint. The medical name for it is subacromial bursitis.

Bursitis is painful swelling in a small, fluid-filled sac called a bursa. Bursae (the plural of bursa) cushion spaces around bones and other tissue.

The subacromial bursae in your shoulder cushion the area between your rotator cuff tendons and the acromion — the highest point of your shoulder blade (scapula).

Shoulder bursitis happens when something damages or irritates the bursae in your shoulder. That causes inflammation that leads to symptoms like pain and swelling.

Types of shoulder bursitis

There are three types of shoulder bursitis:

• Chronic: Chronic is the medical name for a condition or issue that comes back (recurs). Chronic shoulder bursitis is having repeated episodes of bursitis in your shoulder, usually from experiencing similar injuries or overuse. It’s the most common type.
• Acute: Acute bursitis happens suddenly as a one-off episode, usually after an injury.
• Infectious (septic): This is bursitis that happens when an infection somewhere else in your body spreads to your shoulder bursae.

What are shoulder bursitis symptoms?

The most common symptoms of bursitis in your shoulder include:

• Shoulder pain
• Swelling
• Stiffness
• A reduced range of motion (how far you can move your shoulder without pain)
• Tenderness to even a light touch
• Discoloration or redness on your skin
• A feeling of heat or warmth

What does shoulder bursitis feel like?

Shoulder pain from bursitis can come on suddenly or build up gradually. You may feel a dull ache all the time. But the pain may become sharp or feel like a pinch inside your shoulder when you lift your arm over your head.

You’ll probably feel more (or worse) pain if you sleep or lay on your affected shoulder.

What causes shoulder bursitis?

Injuries and overusing your shoulder are the most common causes of bursitis. Specifically, sports injuries or repetitive strain injuries are usually what cause chronic and acute shoulder bursitis.

Any injury that damages your shoulder can irritate the bursae and cause inflammation. Using your shoulder for a repetitive motion can irritate your bursae. That’s especially true for movements that require a lot of force — like swinging a hammer or throwing a ball. A motion may not hurt at first, but if you keep doing it often, your shoulder may not have time to heal and irritation can build up over time.

Infections from another place in your body that spread to the bursae in your shoulder cause infectious shoulder bursitis. Bacterial infections (like staph infections) are the most common causes.

What are the risk factors?

Anyone can experience shoulder bursitis. But you have a higher risk if you:

• Play a sport that requires you to do repetitive motions with your shoulder (like throwing, rowing or swinging a bat, club or racket)
• Do physical work that puts a lot of stress on your shoulders, like working with tools or lifting heavy objects; people like painters, carpenters, landscapers, plumbers and warehouse workers have a higher risk than other types of workers
• Have a health condition that causes inflammation in your body

Some conditions that may increase your risk of bursitis include:

• Inflammatory arthritis (like rheumatoid arthritis, gout or psoriatic arthritis)
• Diabetes
• Chronic kidney disease
• Thyroid disease

What are the complications of shoulder bursitis?

Chronic shoulder bursitis and repeated flare-ups (periods of symptoms that come and go) can damage your bursae. Over time, this may affect your shoulder’s mobility (how well you can move it).

Bacteria that cause infectious (septic) shoulder bursitis can spread to organs and other parts of your body if the infection isn’t treated. Severe infections can cause sepsis, which can be fatal. This is rare, but it’s important to see a healthcare provider right away if you think you have an infection.

How is shoulder bursitis diagnosed?

A healthcare provider will diagnose bursitis in your shoulder with a physical exam to check the pain and your range of motion. Your provider may use a few different tests to diagnose bursitis and rule out other conditions or injuries that cause similar symptoms, including:

• Shoulder X-rays to check for arthritis or bone spurs
• MRI (magnetic resonance imaging) or ultrasound to look for inflammation in your bursae and/or damage in other parts of your shoulder
• Joint aspiration to drain and test fluid in your bursae for infections or gout
• Blood tests to check for signs of infections

How do I get rid of bursitis in my shoulder?

Usually, rest is all you’ll need to treat bursitis.

Taking a break from activities that put pressure on your shoulder will give it time to heal. Your provider will tell you how long you’ll need to rest and avoid physical activities.

Other shoulder bursitis treatments include:

• Ice: Icing your shoulder can help you manage symptoms. Apply an ice pack a few times a day for 15 minutes at a time. Wrap the ice pack in a thin towel or washcloth to avoid putting it directly on your skin.
• Over-the-counter (OTC) pain relievers: Taking over-the-counter NSAIDs (nonsteroidal anti-inflammatory drugs) or acetaminophen can relieve pain and reduce inflammation. Don’t take these medicines for more than 10 days in a row without talking to your provider.
• Corticosteroids: These are prescription anti-inflammatory medications. Your provider may inject cortisone shots directly into your shoulder.
• Physical therapy (PT): PT can help you strengthen your shoulder muscles and increase flexibility. This can help manage bursitis symptoms and prevent future injuries.
• Antibiotics: You’ll need antibiotics if you have infectious bursitis. Make sure you take the full dose of antibiotics for as long as your provider says, even if you start to feel better.
• Joint aspiration: Your provider may use aspiration to drain extra fluid out of your bursae.

Shoulder bursitis surgery

It’s rare to need surgery for shoulder bursitis. Your provider will usually only recommend surgery if you have severe symptoms that don’t get better after trying other treatments. You’re more likely to need surgery if you have chronic shoulder bursitis that makes it hard to do all your daily activities.

Shoulder bursitis surgery is usually done with a shoulder arthroscopy. Your surgeon will remove or repair damaged tissue in your shoulder joint. They may also remove the inflamed bursae to create more room inside your shoulder. Your surgeon will tell you what to expect and how long it’ll take to recover.

How can I prevent shoulder bursitis?

You can reduce your risk of chronic shoulder bursitis by:

• Stretching and warming up your shoulders before physical activities
• Strengthening your shoulders with sport-specific exercises or exercises customized to your job or hobbies
• Taking breaks between training sessions or work that puts a lot of stress on your shoulders
• Avoiding “playing through the pain” or forcing yourself to keep using your shoulder if it hurts during or after physical activities

You may not be able to prevent acute shoulder bursitis because it happens after sudden injuries you can’t plan for.

It might also be hard to prevent infectious bursitis. You can’t control how an infection spreads inside your body. If you’re taking an antibiotic to treat an infection, take the full dose for exactly as long as your provider prescribes. That’s the best way to make sure it completely kills the infection and reduces the risk of it spreading.

How long does shoulder bursitis last?

How long shoulder bursitis lasts depends on which type you have and what caused it. Most people experience symptoms for a few weeks.

Your provider or physical therapist may suggest that you keep managing shoulder bursitis even after your symptoms get better. They may suggest a few months of physical therapy and other treatments to help reduce your risk of the bursitis coming back.

When should I see my healthcare provider?

Visit a healthcare provider if you experience:

• Pain or limited range of motion in your shoulder or arm that interferes with your daily routine, including your sleep
• Pain that doesn’t improve with at-home treatments
• Shoulder or arm weakness
• Signs of infection, like a fever or chills
• Discoloration, redness or swelling around your shoulder

Which questions should I ask my provider?

It may be helpful to ask your provider:

• Which type of bursitis do I have?
• How long should I rest and avoid physical activities?
• Will I ever need surgery for bursitis?
• How can I modify my activities to avoid chronic bursitis?