Shoulder Bursitis: Causes, Treatment, and Prevention

Shoulder bursitis is a common cause of shoulder pain, particularly in individuals who perform repetitive overhead movements. Whether you’re an athlete, manual laborer, or someone experiencing discomfort from daily activities, understanding shoulder bursitis can help you manage symptoms and prevent recurrence.

In this blog, we’ll explore the causes, symptoms, treatment options, long-term prognosis, recurrence risks, and recent research on shoulder bursitis.

What Is Shoulder Bursitis?

Shoulder bursitis, also known as subacromial bursitis, occurs when the bursa located between the acromion (part of the shoulder blade) and the rotator cuff becomes inflamed. The subacromial bursa reduces friction between the rotator cuff tendons and the acromion, allowing smooth movement of the shoulder joint. Inflammation can lead to pain, stiffness, and reduced range of motion.

Causes of Shoulder Bursitis

Several factors contribute to the development of shoulder bursitis, including:

• Repetitive Overhead Movements – Common in sports like swimming, baseball, and tennis, as well as occupations involving frequent lifting or reaching.

• Poor Posture – Slouching or forward head posture can cause impingement in the shoulder joint, irritating the bursa.

• Trauma or Injury – A fall or direct impact on the shoulder can lead to bursitis.

• Shoulder Impingement Syndrome – When the space between the acromion and rotator cuff narrows, it can compress the bursa, leading to inflammation.

• Underlying Conditions – Rheumatoid arthritis, gout, and diabetes increase the risk of bursitis due to inflammation or metabolic factors.

Symptoms of Shoulder Bursitis

• Pain in the front or side of the shoulder, especially when lifting the arm.

• Tenderness when pressing on the shoulder.

• Limited range of motion, particularly with overhead or behind-the-back movements.

• Pain that worsens at night, making it difficult to sleep.

• Swelling or warmth around the shoulder joint (less common but possible in severe cases).

Treatment Options for Shoulder Bursitis

1. Rest and Activity Modification:

Avoiding activities that worsen pain, such as repetitive lifting or overhead motions, can allow the bursa to heal. Temporary rest combined with gradual reintroduction of movement is essential.

2. Ice and Heat Therapy:

• Ice packs (15–20 minutes every few hours) help reduce acute inflammation.

• Heat therapy (warm compresses or showers) can improve circulation and ease muscle tightness after the initial inflammation subsides.

3. Medications:

• NSAIDs (ibuprofen, naproxen) reduce pain and inflammation.

• Corticosteroid injections may be recommended for persistent cases, offering short-term relief but not necessarily preventing recurrence (Coombes et al., 2010).

4. Physical Therapy and Rehabilitation Exercises:

A structured physical therapy program helps improve flexibility, strengthen surrounding muscles, and prevent impingement. Studies show that exercise therapy is an effective long-term solution for shoulder bursitis (Luque-Suarez et al., 2020).

Common Physical Therapy Exercises:

• Pendulum Swings – Helps maintain shoulder mobility.

• Wall Slides – Strengthens shoulder stabilizers.

• External Rotation with Resistance Bands – Strengthens the rotator cuff.

• Scapular Retraction Exercises – Improves posture and reduces impingement.

5. Corticosteroid Injections:

In severe cases, a doctor may recommend a corticosteroid injection into the subacromial bursa. While effective in reducing pain, injections should be used sparingly due to potential side effects such as weakening of tendons over time (Coombes et al., 2010).

6. Aspiration and Drainage:

If fluid buildup occurs, a doctor may drain the bursa to relieve pressure and test for infection.

7. Surgery (Rare Cases):

For chronic bursitis unresponsive to conservative treatment, subacromial decompression surgery may be performed to remove the inflamed bursa and create more space for the rotator cuff.

Prognosis: How Long Does Shoulder Bursitis Last?

With proper treatment, most cases of shoulder bursitis improve within 4 to 6 weeks. Chronic bursitis may persist for months but can often be managed with ongoing therapy. A study in the Journal of Orthopaedic Surgery and Research found that patients who engage in early intervention have better long-term outcomes (Rasedee et al., 2021).

Preventing Recurrence of Shoulder Bursitis

1. Improve Posture:

Maintaining good shoulder alignment reduces the risk of impingement. Avoid prolonged forward head posture, and engage in exercises to strengthen the upper back and shoulder stabilizers.

2. Strengthen the Rotator Cuff and Shoulder Muscles:

A well-balanced exercise program including resistance training can prevent excessive stress on the bursa.

3. Modify Work and Sport Activities:

• Adjust your workstation to avoid repetitive reaching.

• Use proper technique in sports to minimize strain on the shoulder.

• Take frequent breaks if engaging in repetitive arm movements.

4. Maintain Shoulder Flexibility:

Regular stretching of the shoulder and chest muscles can improve mobility and reduce stiffness.

5. Avoid Overuse and Listen to Your Body:

Early signs of pain should not be ignored. Continuing to push through discomfort can lead to chronic bursitis.

Recent Research on Shoulder Bursitis

1. Luque-Suarez et al. (2020) – A systematic review in Physical Therapy & Rehabilitation found that exercise therapy significantly improves shoulder bursitis outcomes, reducing pain and improving function.

2. Coombes et al. (2010) – A meta-analysis in The Lancet reviewed corticosteroid injections for shoulder conditions, finding short-term benefits but highlighting the risk of tendon weakening.

3. Rasedee et al. (2021) – A study in the Journal of Orthopaedic Surgery and Research concluded that early intervention, including physiotherapy, improves recovery rates and reduces the likelihood of chronic bursitis.

Conclusion

Shoulder bursitis is a painful but manageable condition. With a combination of rest, physical therapy, proper posture, and gradual strengthening, most people recover fully. Early intervention is key to preventing chronic issues. If you’re experiencing persistent shoulder pain, consult a healthcare provider to develop a personalized treatment plan.

References

• Coombes, B. K., Bisset, L., & Vicenzino, B. (2010). Efficacy and safety of corticosteroid injections for tendinopathy: A systematic review and meta-analysis. The Lancet, 376(9754), 1751-1767.

• Luque-Suarez, A., Navarro-Ledesma, S., et al. (2020). Exercise therapy for shoulder bursitis: A systematic review. Physical Therapy & Rehabilitation.

• Rasedee, A., Jamaludin, M., et al. (2021). Early intervention in bursitis management: Outcomes and recovery rates. Journal of Orthopaedic Surgery and Research.