Shoulder Bursitis Treatment
A bursa is a thin fluid filled sac that lets tissues glide past one another without friction, and the shoulder has one sitting between the rotator cuff tendons and the bone above them. When that sac becomes inflamed it thickens and swells, taking up space in a corridor that had none to spare, which is why bursitis and impingement so often arrive together.
Bursitis is one of the shoulder conditions most likely to resolve without an operation, and treating it as though it will not is a common error. Steven Struhl, MD is board certified in orthopedic surgery and separately in sports medicine, has practiced in New York since 1991, and is a Fellow of the American Academy of Orthopaedic Surgeons.
What Shoulder Bursitis Is
The subacromial bursa sits beneath the acromion, the bony shelf projecting from the shoulder blade, and above the rotator cuff. Inflammation there is rarely an isolated event. It usually accompanies something else, most often tendon irritation or mechanical impingement, which is why treating the bursa alone tends to produce temporary relief.
- Repetitive Overhead Use: the most common cause, from work or from sport.
- Impingement: narrowing of the space compresses and irritates the bursa.
- Direct Trauma: a fall onto the shoulder producing acute inflammation.
- Inflammatory Conditions: rheumatoid arthritis and similar conditions affecting the lining.
Shoulder Bursitis Symptoms
- Pain On The Outer Shoulder: often felt down the side of the upper arm rather than at the joint.
- Pain Reaching Overhead: discomfort in a specific arc during elevation.
- Night Pain: difficulty lying on the affected side.
- Tenderness To Pressure: soreness when the outer shoulder is pressed.
Treatment
- Activity Modification: reducing the overhead loading that provoked it, without full rest.
- Anti Inflammatories: oral medication during the acutely inflamed period.
- Physical Therapy: restoring scapular control and rotator cuff strength.
- Subacromial Injection: corticosteroid placed directly into the bursa.
Most cases settle over weeks with these measures. What matters more than the treatment of the bursa itself is identifying what irritated it, since a bursa inflamed by poor shoulder mechanics will inflame again once the injection wears off.
When Surgery Is Considered
Rarely, and only after conservative treatment has had a genuine trial. Where surgery is performed it is generally a subacromial decompression, which widens the space beneath the acromion rather than removing the bursa in isolation. That distinction matters, because the problem is usually the space rather than the sac.
Schedule a Shoulder Evaluation in New York City
Pain down the outside of the upper arm that worsens reaching overhead and interferes with sleep is a recognizable pattern, and the useful part of an evaluation is determining what is irritating the bursa rather than simply confirming that it is irritated. Dr. Struhl evaluates shoulder bursitis at his Manhattan and White Plains offices. Contact the practice to schedule an appointment.
