Shoulder Bursitis

Shoulder bursitis is a common condition that causes pain and stiffness in the shoulder. It happens when the small fluid-filled sacs, called a bursae, become irritated or inflamed. Bursae act like cushions between bones, tendons, and muscles, helping your shoulder move smoothly. When one of these sacs becomes inflamed, it can make even simple movements, like reaching overhead or getting dressed, painful. Shoulder bursitis often develops gradually, but it can also come on suddenly after an injury or repeated strain. While it can affect anyone, it is especially common in people who perform repetitive shoulder motions, such as athletes, painters, or those with physically demanding jobs.

What are the symptoms?

The most noticeable symptom of shoulder bursitis is pain in the outer or top part of the shoulder. This pain may start as mild discomfort and worsen over time, especially with movement. Many people feel increased pain when lifting their arm, reaching behind their back, or lying on the affected side. The pain can also radiate down the upper arm, making it difficult to pinpoint the exact source.

Stiffness is another common symptom. You may notice your shoulder feels tight or harder to move, particularly after periods of rest. Some people experience a reduced range of motion, making it difficult to complete everyday activities like combing their hair or putting on a jacket.

Swelling and tenderness can also occur, although these symptoms are often less visible than in other parts of the body. The shoulder may feel warm to the touch, and pressing on certain areas can trigger discomfort. In more severe cases, the pain may persist even when the shoulder is at rest, and it can interfere with sleep.

What causes shoulder bursitis?

Shoulder bursitis is usually caused by irritation or overuse of the shoulder joint.

• Repetitive movements, especially those that involve lifting the arm overhead, are a leading cause. Activities like swimming, tennis, weightlifting, or even repetitive tasks at work can put ongoing stress on the bursa, leading to inflammation over time. Jobs or hobbies that require repeated shoulder movements—such as construction work, painting, gardening, or sports—can increase wear and tear on the shoulder over time. Without proper rest and recovery, this repeated stress can lead to inflammation.
• Injury is another common cause. A direct blow to the shoulder or a fall can irritate the bursa and trigger inflammation. Previous shoulder injuries can make you more susceptible as well. If you have had a shoulder strain, tear, or dislocation in the past, your shoulder mechanics may be altered, increasing the likelihood of bursitis. Even minor injuries can lead to bursitis if the shoulder does not have enough time to heal properly.
• Poor posture can also contribute to shoulder bursitis. Slouching or holding the shoulders in an unnatural position for long periods can place extra pressure on the shoulder structures, including the bursa. Over time, this added strain can lead to irritation and inflammation.
• In some cases, shoulder bursitis is linked to other conditions, such as rotator cuff problems or arthritis. When nearby tendons or joints are inflamed or damaged, they can affect how the shoulder moves, increasing friction and stress on the bursa.
• Age is one of the most significant. As you get older, the tissues in your shoulder naturally lose some flexibility and strength, making them more prone to irritation and injury.
• Muscle imbalances can also raise your risk. Weak or tight muscles around the shoulder can affect how the joint moves, putting extra pressure on the bursa. This is especially common in people who spend long hours sitting at a desk or using a computer without proper ergonomic support.
• Certain medical conditions can also play a role. Inflammatory conditions, such as rheumatoid arthritis, can increase the risk of bursitis by causing widespread joint inflammation. Diabetes and other chronic conditions may also affect how well your body heals, making it easier for irritation to develop into a more persistent problem.

How is shoulder bursitis diagnosed?

Diagnosing shoulder bursitis typically begins with a thorough medical history and physical examination. Your orthopedic clinician will ask about your symptoms, including when the pain started, what activities make it worse, and whether you have had any recent injuries. Understanding your daily activities and lifestyle can also help identify possible causes.

During the physical exam, your shoulder will be gently moved in different directions to assess your range of motion and pinpoint areas of pain. Certain movements may reproduce your symptoms, helping your provider determine whether the bursa is involved. They may also check for tenderness, swelling, and signs of weakness in the surrounding muscles.

In some cases, imaging tests may be recommended to confirm the diagnosis or rule out other conditions. X-rays can help identify bone-related issues, such as arthritis or bone spurs, although they do not show soft tissues like bursae. Ultrasound or MRI scans provide a more detailed view of the soft tissues and can reveal inflammation in the bursa or problems with nearby tendons.

Sometimes, they may use a diagnostic injection. This involves injecting a small amount of numbing medication into the shoulder. If the pain improves significantly after the injection, it can help confirm that the source of the discomfort is related to inflammation in the bursa.

An accurate diagnosis is important because shoulder pain can have many different causes, including tendon injuries, joint problems, or nerve issues. Identifying shoulder bursitis early allows for more effective treatment and helps prevent the condition from becoming chronic or more difficult to manage.

When you or a loved one is suffering with should pain and stiffness contact Orthopedic Associates of Northern California to schedule a consultation with one of our board-certified and fellowship- trained orthopedic professionals. Our goal is to get you back to the life you love.