Shoulder bursitis is a painful condition that arises from inflammation in the bursa. The bursa is a fluid filled sac that provides cushioning between tendon and bone. The most commonly affected bursa in the shoulder is the sub-acromial bursa. Shoulder bursitis is often accompanied by tendinitis of the adjacent tendons.
Normally, the tendons glide smoothly within the sub-acromial space. However in some people, the space can become too narrow for normal motion, which causes irritation to the tendons and bursa, resulting in inflammation. The inflammation then causes the tendons and bursa to swell, making the subacromial space even smaller, and the tendons can become impinged between the bones. This results in pain when moving your shoulder and lifting your arm.
Bursitis can be either acute or chronic. Chronic bursitis often occurs due to repetitive stress and irritation of the bursa, whereas acute bursitis typically occurs after trauma. In overuse injuries, shoulder bursitis commonly occurs alongside impingement and tendinopathy of the rotator cuff tendons.
Shoulder bursitis can be diagnosed by a physiotherapist, who will take a thorough history and perform a physical examination of your shoulder. An ultrasound scan can help confirm the diagnosis.
Common activities that irritate the bursa
- Lifting something too heavy
- Lifting at an awkward angle
- Lifting a heavy object away from the body or above shoulder height
- Repetitive movements that place stress on the shoulder
- Reaching behind the backseat of your car to lift or place heavy items
Symptoms of bursitis
- Pain at the front or side of the shoulder
- Reduced range of motion
- Weakness in the arm
- Difficulty with overhead movements
- Pain or discomfort when reaching behind your back
- Pain lying on the affected side
- Difficulty sleeping due to pain
How to treat shoulder bursitis
The first step in treating shoulder bursitis is reducing the inflammation. This involves resting your shoulder, and avoiding activities that aggravate the pain. This may mean taking a short break from sport. Anti-inflammatory medication can also be taken to help reduce the inflammation.
Once your pain is under control, you can begin working to regain your full range of motion and strength. This will involve performing specific exercises designed to address your weakness and tightness.
As your pain continues to improve, and your strength, flexibility, and stability improve, you will be able to begin a graded return to sport and activity as guided by a Physiotherapist.
Physiotherapy management is very effective in treating shoulder bursitis. Keep reading to learn more about how we can help.
How can a physiotherapist help me with shoulder bursitis?
Shoulder bursitis can be treated with conservative physiotherapy management. This usually involves soft tissue massage and joint mobilisations to help improve muscle tightness and joint stiffness. Other modalities such as ultrasound, heat packs and TENS can be used for pain relief. Your physiotherapist will address various factors that could be contributing to the bursitis, such as posture, muscle flexibility, shoulder stability, and strength of the rotator cuff muscles. You will be prescribed specific exercises consisting of stretches and strength work that are individually tailored to your needs. You will be given important advice on posture, desk set up and sleeping positions to reduce the stresses placed on the shoulder. Any necessary modifications to your daily activities will also be suggested.
In cases where the symptoms are persistent and do not resolve, your doctor may suggest a corticosteroid injection to help reduce the inflammation and provide pain relief.