A bursa is a sac (containing a small amount of fluid) located between tendons and bone or other moving parts. A bursa reduces friction between bones and tendons, or other neighboring parts, during movement of a joint. Bursitis is an inflammation of a bursa.
Causes of Shoulder Bursitis
The shoulder joint is a common location for bursitis. Bursitis is often caused by overuse of the shoulder. It may also be caused by an acute injury. Shoulder bursitis may occur on its own, but frequently occurs with rotator cuff injuries such as tendonitis and/or shoulder impingement syndrome.
Shoulder tendonitis and bursitis are are often caused by repetitive overhead activities. Overhead movements can cause compression of both the rotator cuff tendons and the bursa that lies under the roof of the shoulder blade. Repetitive overhead movements may lead to irritation and inflammation of either the rotator cuff tendons or the bursa. A torn, frayed, or inflamed tendon may cause irritation of a bursa. A bone spur on the roof of the shoulder blade may also irritate the bursa and cause bursitis. A calcium deposit in the rotator cuff tendon may also irritate the bursa and cause bursitis.
If the rotator cuff muscles (the rotator cuff is a group of four muscles and their tendons, which support the shoulder joint during movement) become fatigued or are simply weak, they may fail to properly stabilize the shoulder joint during overhead movement. This results in even more impingement of the tendons and bursa.
Sometimes bursitis occurs along with other diseases such as rheumatoid arthritis or gout. In some cases, the cause its unknown.
Symptoms of Shoulder Bursitis
Bursitis often develops quickly, over a period of a couple of days. Symptoms of shoulder bursitis include pain, limited range of motion, inflammation, and sometimes warmth and redness of the skin over the area. Moving the shoulder intensifies the pain. Symptoms are similar to rotator cuff tendonitis but bursitis is more likely to be accompanied by swelling.
The bursa may become infected. If there is redness, warmth and swelling, see a physician. An infection of the bursa requires treatment with antibiotics.
Treatment of Shoulder Bursitis
The treatment for shoulder bursitis is basically the same as treatment for rotator cuff injury. Relative rest, using ice packs and medications to reduce pain and inflammation, exercises to prevent stiffness and, when sufficient healing has occurred, exercises to strengthen the rotator cuff, which dynamically supports the shoulder joint.
Recovery time varies, depending on how severe the inflammation is and how early treatment is started. It may take a couple of weeks or a couple of months. Bursitis often resolves within a couple of weeks as long as the shoulder is rested as soon as the symptoms start. Rest means that the shoulder is not subjected to the same activity that caused the injury (if it can be identified) or any activity that aggravates the pain – especially overhead movement. Continuing to use the shoulder in everyday activities prevents the muscles that support the shoulder from weakening. Ignoring the pain and continuing activities that cause pain causes more inflammation and delays healing.
Applying ice covered in cloth for 20 minutes at time, every 3 -4 hours, is especially beneficial during the first couple of days of symptoms. Cold minimizes inflammation and accelerates healing. It also numbs pain.
Do not use ice if you have nerve damage or circulatory problems, unless advised to do so by a physician.
Anti-inflammatory medication such as Aspirin or ibuprofen relieves pain and inflammation and is usually safe for short-term use.
An injection of cortisone (a steroid with powerful anti-inflammatory properties) into the bursa often brings quick relief of symptoms. As very little cortisone gets into the bloodstream, systemic side effects are minimal. Many physicians limit the number of cortisone injections into the same area to three as excessive cortisone can weaken the tissues.
Stretching exercises help prevent stiffness of the shoulder. Strengthening exercises for the rotator cuff can help stabilize the shoulder. A strong rotator cull can help prevent soft tissue injuries, such as shoulder bursitis or rotator cuff tendonitis, from recurring.