Shoulder Bursitis

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KEY POINTS

• Bursitis is irritation and swelling a fluid-filled sac that acts as a cushion between bone and other tissues, such as skin, muscle, tendons, or ligaments. There are several bursae in your shoulder.
• You need to change or stop doing the activities that cause pain until the bursa has healed. Treatment may include removing fluid from the swollen area with a needle and syringe, medicine, or surgery.
• To help prevent bursitis, warm up properly and stretch your shoulder before activities such as throwing, playing tennis, or swimming.

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What is shoulder bursitis?

Bursitis is irritation or swelling of a bursa. A bursa is a fluid-filled sac that acts as a cushion between bone and other tissues, such as skin, muscle, tendons, or ligaments. Tendons are strong bands of tissue that attach muscle to bone. Ligaments are strong bands of tissue that connect one bone to another to form the joints.

There are several bursae in your shoulder. A bursa that is only mildly irritated may improve within a few weeks with treatment. A bursa that is very swollen and irritated, or has been painful for a long time, may take months to improve.

What is the cause?

Common causes include:

• Injury to your shoulder, for example, from a fall
• Overuse injuries of your shoulder during sports, work, or hobbies. For example, shoulder bursitis is more common in people who often swim, or play tennis or baseball. Painters and carpenters may also get shoulder bursitis.
• Infection from a cut or a scrape on the skin over a bursa

Other possible causes or risk factors for developing shoulder bursitis include:

• Arthritis, which is pain and swelling of a joint
• Gout or pseudogout, which is pain and swelling caused by a buildup of crystals in your joints and under your skin
• An autoimmune disease, such as rheumatoid arthritis or lupus, which causes your body to mistakenly attack your own tissue

What are the symptoms?

Symptoms may include:

• Pain on the outer front side of your shoulder or when you lift your arm above your head
• Swelling in your shoulder

If the bursa is infected, you may have a fever or the swollen area may feel warm.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. Tests may include:

• An ultrasound, which uses sound waves to show pictures of the joint
• Joint aspiration, which uses a needle and syringe to remove a sample of fluid from the bursa. The fluid can be checked for infection and other causes of the bursitis. Removing some of the fluid can also help the pain.
• You may have tests or scans to check for other possible causes of your symptoms, such as blood tests, X-rays, or an MRI, which uses a strong magnetic field and radio waves to show detailed pictures of the joint

How is it treated?

To relieve symptoms of bursitis:

• You need to change or stop doing the activities that cause pain until the bursa has healed.
• Put an ice pack, gel pack, or package of frozen vegetables wrapped in a cloth on the area every 3 to 4 hours for up to 20 minutes at a time to help relieve pain.
• Take nonprescription pain medicine, such as acetaminophen, ibuprofen, or naproxen. Read the label and take as directed. Unless recommended by your healthcare provider, you should not take these medicines for more than 10 days.
  • Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Putting an NSAID gel on your skin can decrease pain, with fewer side effects than pills taken by mouth. Ask your healthcare provider if a prescription is right for you.
  • Acetaminophen may cause liver damage or other problems. Unless recommended by your provider, don't take more than 3000 milligrams (mg) in 24 hours. To make sure you don’t take too much, check other medicines you take to see if they also contain acetaminophen. Ask your provider if you need to avoid drinking alcohol while taking this medicine.
• Follow your provider’s instructions for doing exercises to keep your range of motion, keep the joint from getting stiff, and help the joint get stronger.

If you keep having symptoms:

• Your healthcare provider may remove fluid from the swollen area with a needle and syringe. Your provider may then wrap the injured site or put a splint on it to keep fluid from refilling the area and to prevent you from moving it.
• Your provider may inject the inflamed area with a steroid medicine and a local anesthetic so you will have less swelling, redness, and pain.
• Your provider may recommend surgery if the joint keeps bothering you even after treatment.

Follow the full course of treatment prescribed by your healthcare provider. Ask your provider:

• How long it will take to recover
• If there are activities you should avoid and when you can return to your normal activities
• How to take care of yourself at home
• What symptoms or problems you should watch for and what to do if you have them

Make sure you know when you should come back for a checkup. Keep all appointments for provider visits or tests.

How can I prevent shoulder bursitis?

You may need to change or stop doing activities that cause pain. Follow safety rules and use any protective equipment recommended for your work or sport. Be sure to warm up properly and stretch your shoulder before activities such as throwing, playing tennis, or swimming. If your shoulder starts to hurt during these activities, you may need to slow down until the pain goes away.