Shoulder Bursitis


Have you ever given up reaching the highest shelf because of the sharp pain in your upper arm? Or have you ever got up in the middle of the night because the pain in your shoulder has woken you up. If you have and don’t know what it is, here is an attempt to tell you what its all about.

The condition of acute shoulder pain is more often than not, a condition defined as shoulder bursitis. In medical parlance, it is also very closely related to shoulder tendonitis or rotator cuff tendonitis, so much so that its often categorised under the term shoulder impingement syndrome. The doctor may diagnose either since all are basically different names for a very similar medical condition.

What causes shoulder bursitis?

To understand the causes, it is important to know the structure of the shoulder joint. The shoulder joint is formed by the upper end of the upper arm bone (humerus) and the tip of the shoulder (acromion). Muscles, tendons and bones make up the complex shoulder joint. The two bones are separated by a set of rotator cuff tendons and the bursa that acts as a protection to the tendons. Under normal circumstances, these bones and tendons slide effortlessly in this space.

If, under any circumstances, these tendons get inflamed and the space between the bones decreases, it leads to a “pinching” of the rotator cuff tendon. And this is what causes that sharp pain in the shoulder. The bursa sitting on top of the tendon to cushion it can also get inflamed, thus restricting the tendon even more.

When does the “pinch” take place?

In some people, the space between the tendons is narrow naturally. This is because of the shape of the bones. In such a case, the slightest of inflammation causes the symptom of shoulder bursitis. In others, an initial injury may cause inflammation. From then on, the process becomes self-exacerbating. With the thickening of the tendons and bursa, the space decreases. And every time the bones move, the “pinch” is felt again. And due to the pinch, the location gets even more inflamed.

The symptoms of shoulder bursitis are quite common. Your shoulder and upper arm causes pain whenever you raise your hand above your head level. At night, your sleep gets disturbed when your shoulder pinches if you lie on the bad side. You know it is shoulder bursitis or impingement when you feel the pain on the outside of your upper arm and shoulder, and deep in the joint.

What are the treatment options for shoulder bursitis?

It goes without saying that the first step to treating shoulder bursitis must be to reduce the inflammation. And the best way to reduce inflammation is to avoid doing things that cause inflammation. For example, do not try to reach for things kept very high if it causes pain. Prevention is the best cure. If the inflammation or the manifestation of it, pain, persists, anti-inflammatory medicines also help.

However, anti-inflammatory drugs that are non-steroidal in nature cannot be and should not be taken continuously. Once the initial inflammation subsides, some simple physical exercises are enough to help treat this condition.

Exercises that strengthen rotator cuff muscles should be done to help cure shoulder bursitis. Also the use of ice and heat can be particularly beneficial. All are covered in my book, including lots of other tips and tricks you can use to reduce your pain.

If the condition fails to improve, only then cortisone injections or steroids are pushed into the inflamed region. However, it is not advisable since repeated cortisone injections weaken tendons.

Surgery to cure shoulder bursitis is not unheard of but not very common either. Only if non-surgical methods have failed after 6 months of diagnosis, surgery may be considered. This is usually only warranted if there is some arthritis in the shoulder.