Shoulder Bursitis

Shoulder Bursitis

What is Shoulder Bursitis?

Bursae are small, fluid-filled sacs located in the shoulder and in other joints throughout the body. The bursae act as cushions between bones and the overlying soft tissues, helping to reduce friction between the moving parts: muscles and the bone.

Sometimes excessive use can cause the shoulder joint to become inflamed, with a related, painful swelling of the bursa between the rotator cuff and a part of the shoulder blade known as the acromion. This condition is known as subacromial bursitis. Bursitis can also occur in association with rotator cuff tendinitis. The pain of shoulder bursitis can interfere with your ability to do daily activities, such as combing your hair or getting dressed.

What causes it?

Doing the same kinds of movements repeatedly every day or putting stress on joints increases the risk of bursitis. Carpenters, gardeners, musicians, and athletes whose work involves repeated motion of the shoulder under stress can get bursitis. Infection, arthritis, gout, thyroid disease, and diabetes can also cause swelling of a bursa; bursitis can become more likely and more frequent as you get older.

What are the symptoms and diagnosis of shoulder bursitis?

Symptoms. The main symptoms of shoulder bursitis are swelling, stiffness and pain when moving the shoulder. Rheumatoid arthritis also can inflame the rotator cuff and result in bursitis. Any of these can lead to severe swelling and impingement. Diagnosis. Diagnosis of bursitis begins with a medical history and a physical examination. You can expect to be asked to describe the severity of your pain, and discuss when and where it occurs, for example if it gets better or worse during the day. Another important clue is whether there’s anything you do to make the pain go away or come back.

Your doctor may conduct other diagnostic tests, including:

  • Selective tissue tension test to highlight affected areas.
  • Palpation or touching specific areas to pinpoint the swelling.
  • X ray to rule out arthritis or bone problems.
  • MRI, which can reveal damage to both bone and soft tissue.
  • Anesthetic injection test to see if the pain goes away.
  • Sampling fluid from the swollen area to rule out infection.

What is the treatment for Shoulder Bursits?

Treatment aims at healing the injured bursa, first by reducing pain and swelling, with rest, wrapping or elevating the affected area or using nonprescription pain relievers such as acetaminophin or ibuprofene. If the injury is recent, ice may be helpful, but ice doesn’t help much over the longer term. A health care provider, therapist or trainer may suggest longer use of ice along with a stretching program. Your health care provider may also suggest limiting activities that involve the affected joint.

Other treatments may include:

  • Ultrasound; gentle sound-wave vibrations that warm deep tissue and improve blood flow
  • An electrical current that pushes a corticosteroid drug through the skin directly over the swollen bursa
  • Gentle stretching and strengthening exercises
  • Massage of the soft tissue

Can Shoulder Bursitis be Prevented?

Here are some ideas to help prevent swelling or reduce the number of flare-ups from bursitis:

  • Warm up or stretch before exercise.
  • Strengthen the muscles around the joint.
  • Take frequent breaks from repetitive tasks.
  • Use a two-handed backhand in tennis.
  • Use two hands to hold heavy tools.
  • Position your body properly when doing daily tasks.
  • Begin new activities or exercises slowly.

If you have a history of bursitis, be sure and discuss any new exercise regimen with your doctor before beginning.

Sources

UpToDate.com Bursitis Beyond the Basics http://www.uptodate.com/contents/bursitis-beyond-the-basics?view=print

NIAMS What are bursitis and tendinitis Fast Facts http://www.niams.nih.gov/Health_Info/Bursitis/bursitis_ff.asp

AAOS - Shoulder Pain and Common Shoulder Problems http://orthoinfo.aaos.org/topic.cfm?topic=A00065