Inside each of your shoulders is a tiny, fluid-filled sac known as a bursa. Bursae help reduce friction between the bones in your joints. If the bursa in your shoulder becomes inflamed, it leads to a condition known as shoulder bursitis.
Causes can include injury, overuse, or medical conditions that cause joint inflammation, such as rheumatoid arthritis. Shoulder bursitis is also known as “subacromial bursitis.” It can be treated in a variety ways, both at home and in a doctor’s office.
The shoulder bursa acts as a cushion for a tendon in your rotator cuff that connects bone to bone. If you have bursitis, certain movements of your shoulder and the tendon can cause significant pain and discomfort. The pain can vary based on your specific injury. However, some of the more common symptoms of bursitis are:
- discomfort when lying on your shoulder
- pain on the outside or top of your shoulder
- pain that gets worse when you lift your arm to the side
- pain when pushing on or opening a door
- pain when trying to “circle” your arm
- pressure and pain when pushing on the top of your shoulder
Some people are at higher risk for shoulder bursitis because they use their shoulders more than others. Examples of those who are more prone to bursitis include:
However, anyone can injure their shoulder and develop bursitis.
Because bursitis is often due to inflammation, giving your shoulder enough time to rest can often help reduce symptoms. Examples of some of the at-home steps that can help reduce bursitis symptoms include:
Rest the shoulder
Avoiding activities that you know tend to worsen symptoms can help to reduce your symptoms. Often, this is an activity in an occupation or a frequent pastime.
Take an over-the-counter pain reliever
Nonsteroidal anti-inflammatory drugs (NSAIDs) are especially helpful in reducing inflammation. These include:
- ibuprofen (Advil, Motrin)
- acetaminophen (Tylenol)
- naproxen sodium (Aleve)
Apply an ice pack to the affected area
Always have some kind of protective covering between the ice and your skin. Wear a cold compress for only 10 to 15 minutes at a time.
Wear a shoulder brace
A shoulder brace can help serve as a reminder to rest your arm and keep from doing too much. These are available at most drugstores, although you may need a physical therapist or doctor to show you how to correctly wear it.
Perform gentle stretching activities
But don’t stretch to the point of extreme pain or discomfort.
These exercises can be performed two to three times a day to stretch your shoulder muscles, which may help to reduce tension.
- While sitting or standing, bring your arm across your body, placing your hand on the back of the opposite shoulder.
- Use your other hand to press on the back of the elbow to deepen the stretch, feeling the stretch across the back of your shoulder.
- Hold this position for 15 to 30 seconds. Repeat 2 to 4 times.
- Perform the stretch on the opposite side.
Shoulder blade squeeze
- Stand or sit with your arms at your sides. Pull your shoulder back, imagining you are making your shoulder blades touch. Keep your shoulders down as you perform the exercise to feel a greater stretch for the front of the shoulders.
- Hold this position for 6 seconds.
- Repeat the exercise between 6 and 8 times.
Shoulder blade range of motion
- Lift your shoulders up as if you are shrugging them, holding the position for 5 seconds. Lower the shoulders.
- Move your shoulders downward to feel a stretch across the top of the shoulders. Hold this position for 5 seconds.
- Rotate the shoulders in a circular motion backward for 5 circles. Stop and repeat by rotating the shoulders forward.
Corticosteroids and pain medications
If at-home treatments aren’t effective, your doctor may prescribe stronger pain medications. However, these won’t heal the underlying causes of bursitis. Another option is corticosteroid injections around the bursa. However, you can only have a limited number of these injections because they increase the likelihood that you could rupture your tendon.
In rare instances, your doctor may recommend surgery for bursitis. Your doctor usually doesn’t recommend surgery as a treatment unless you have been experiencing problems with little relief for six to 12 months. If you do need surgery, your doctor will most likely do it arthroscopically. This means they will make small incisions in your skin and inserts surgical instruments to remove damaged areas of tissue that may be pressing on or irritating the bursa. Sometimes, a doctor will remove the bursa to create more space for the tendon. Often, a person will participate in some type of physical therapy as a way of enhancing recovery.
Bursitis is often a chronic condition, which means that overuse will often trigger your symptoms. You may be able to identify the triggers associated with your bursitis, such as working out your shoulder muscles too hard. By finding the appropriate activity level, you may be able to reduce the symptoms of bursitis while staying active. However, sometimes only surgery can fully fix the underlying cause associated with bursitis.