Shoulder bursitis is caused by irritation of the shoulder bursa and rotator cuff tendon. The shoulder bursa is a normal cushion that is located between the rotator cuff tendon and the bony roof of the shoulder called the acromion. Shoulder bursitis and rotator cuff tendonitis are caused when the bursa and rotator cuff tendon becomes irritated. The symptoms of shoulder bursitis are frequently pain and clicking in the shoulder area that is aggravated with overhead activities and reaching behind your back. Pain at night when attempting to sleep is also very common. Shoulder bursitis is frequently associated with a bone spur on the undersurface of the acromion that can irritate the shoulder bursa and rotator cuff tendon. Surgical treatment of shoulder bursitis often involves removal of the inflamed irritated bursa and bone spurs. This can be performed through an open incision or through minimally invasive arthroscopic surgery. Arthroscopic surgery utilized small incision where specialized tools can be inserted into the shoulder to remove the inflamed bursa and overlying bone spur. This procedure is performed under general anesthesia, regional anesthesia or a combination of both general anesthesia and regional anesthesia.