Shoulder Bursitis

The symptoms of shoulder bursitis often start gradually but can become more noticeable over time. Common signs include:

• Pain in the top or outer part of the shoulder that may spread down the arm
• Discomfort when lifting the arm, especially overhead
• Pain that worsens at night, making it difficult to sleep on the affected side
• Stiffness or limited range of motion in the shoulder
• Swelling or tenderness around the joint
• A sharp or aching sensation with certain activities, such as reaching behind the back or putting on a jacket

In some cases, shoulder bursitis can develop suddenly after an injury. In others, the symptoms progress slowly due to ongoing irritation or repetitive movements.

Shoulder bursitis may develop for a variety of reasons. The most common causes include:

• Repetitive overhead movements, such as those in swimming, painting, or throwing sports
• Trauma or injury, such as a fall or direct blow to the shoulder
• Overuse from work, sports, or hobbies that strain the shoulder
• Poor posture, which places extra stress on the shoulder joint
• Age-related changes that make the tissues in the shoulder more vulnerable
• Underlying shoulder conditions such as rotator cuff injuries, bone spurs, or arthritis

Anyone can develop shoulder bursitis, but certain factors increase the likelihood:

• Age over 40, as tissues lose elasticity and are more prone to irritation
• Jobs or activities that require frequent overhead use of the arms, such as construction, painting, or sports like baseball and tennis
• Poor posture or weak shoulder muscles that lead to uneven stress on the joint
• Medical conditions such as rheumatoid arthritis, diabetes, or gout that increase inflammation in the body
• Previous shoulder injuries, which can make the joint more susceptible to future problems

If left untreated, shoulder bursitis can limit mobility and affect daily activities. In some cases, chronic inflammation can lead to long-term pain or contribute to other shoulder conditions.

Diagnosing shoulder bursitis begins with a detailed medical history and physical examination. An orthopedic specialist will ask about your symptoms, when they began, and what activities make them worse. During the exam, the doctor may check your shoulder’s range of motion, look for areas of tenderness, and test for signs of weakness.

To confirm the diagnosis or rule out other conditions, imaging tests may be recommended:

• X-rays can show bone spurs or arthritis that may be contributing to irritation.
• Ultrasound provides a clear view of the soft tissues, including the bursae and tendons.
• MRI scans offer detailed images of the shoulder, which may be needed if a rotator cuff tear or other injury is suspected.

In some cases, the doctor may recommend an injection of a local anesthetic into the bursa. If this relieves pain quickly, it supports the diagnosis of bursitis.

Most cases of shoulder bursitis improve with nonsurgical care. Treatment usually focuses on reducing inflammation and restoring comfortable movement. Resting the shoulder, applying ice, and avoiding repetitive overhead activity can help ease irritation. Over-the-counter anti-inflammatory medications may reduce pain and swelling. Physical therapy is often recommended to strengthen the shoulder muscles, improve posture, and prevent future flare-ups.

If symptoms persist, a corticosteroid injection into the bursa may provide longer-lasting relief. In rare cases where conservative treatments do not work, surgery may be considered to remove the inflamed bursa or address underlying problems such as bone spurs.