A bag of lubricating fluid surrounds the muscles and tendons of the shoulder. This bag is called a bursa. Inflammation in a bursa is called bursitis.
There are several bursae around the shoulder. The largest one - and the commonest one to cause a problem is called the sub deltoid bursa or the subacromial bursa (two names for the same bursa)
If this bursa becomes inflamed then a typical pattern of pain develops.
What causes Shoulder Bursitis
Bursitis around the shoulder usually arises after an injury such as a fall or as a result of unaccustomed overuse of the shoulder joint or shoulder muscles.
Sometimes the sufferer will not be able to recall a specific trigger and it can seem as if the pain just starts out of no where.
Bursitis can exist on its own or in association with inflammation of the shoulder tendons. Shoulder tendon inflammation is called tendonitis
How to diagnose Shoulder Bursitis
The symptoms of shoulder bursitis often begin gradually over some weeks or months. Pain is the main problem. Rarely the problem can start with severe pain and progress rapidly but this is not common. More often it starts with a gradual pain in the region of the outer part of the shoulder - over the deltoid muscle.
The pain is felt over the deltoid muscle area around the shoulder. It may spread down the arm towards the elbow or wrist. The pain is made worse by lying on the affected side or by trying to use the arm above the head.
Some people become aware of a "painful arc" of movement. This means that they have no pain when their arm hangs by their side but they develop a pain as they lift their arm up and outwards. The pain often arises when their arm reaches about sixty degrees of elevation. Once they get a bit beyond the ninety degree point, the pain eases again or goes away completely.
If a doctor or therapist resists the patients attempt to lift their arm outwards from the side then the pain will become more pronounced.
Your doctor may perform a maneuver called the Impingement Test to determine whether their is inflammation in the bursa or the tendons of the shoulder.
It is sometimes necessary for the doctor to exclude other problems by performing blood tests or by arranging x-rays or scans. An ultrasound scan is often the most helpful test.
Sometimes MRI scan is required to confirm the diagnosis of bursitis of the shoulder.
How to treat Shoulder Bursitis
One of the most important aspects of treating shoulder bursitis is to stop doing the movement or activity that provoked it in the first place. Of course this may be easier said than done but you might consider changing your technique or equipment if you are involved in sport. If your bursitis has been triggered by work then give some thought to changing the way that you tackle your job tasks and activities.
Treatment options for shoulder bursitis include:
painkiller or anti-inflammation medication
physical therapy from a physiotherapist, chiropractor or osteopath
