Shoulder Bursitis

There are three types of shoulder bursitis: chronic, traumatic and infected. The symptoms of each type may overlap, but they aren’t always the same. Pain on the outer side of the shoulder is the most common symptom with each type of shoulder bursitis. Pain can radiate from the top of the shoulder down the outside of the arm to the elbow, rarely past the elbow. Shoulder bursitis symptoms by type are:

• Chronic shoulder bursitis symptoms include swelling, sometimes with pain, mild warmth or redness

• Traumatic shoulder bursitis symptoms include rapid swelling and tenderness, sometimes with warmth or bruising

• Infected shoulder bursitis symptoms include pain, fever and chills, as well as swelling, heat and redness at the shoulder joint, and sometimes the swelling spreads down the arm

Infected shoulder bursitis, also called septic bursitis, should be treated by a doctor right away so that the infection doesn’t spread. If you have symptoms of infected shoulder bursitis, get immediate medical attention.

Shoulder bursitis is most often caused by overuse, which comes from constantly repeated motions of the joint. As bones continue to rub against a bursa, it can become irritated and then swell, causing bursitis. Many types of sports, such as swimming, golfing, running, or throwing a baseball, require repeated motions in the shoulder, which can sometimes cause too much friction. Without proper technique, stretching or taking breaks between activities, the shoulder joint can develop bursitis. Heavy lifting or overhead work also can cause shoulder bursitis. An injury, such as falling on your shoulder, can cause traumatic bursitis.

Complications from diabetes or from rheumatoid arthritis and gout, which can cause inflammation in the joints, can also result in shoulder bursitis. Septic shoulder bursitis is caused by an infection, typically in people with a weakened immune system.

While not every person who plays baseball or golf or whose job requires heavy lifting will get shoulder bursitis, these people are more at risk for developing the condition. Shoulder bursitis risk factors include:

• Certain pastimes with repetitive arm and shoulder movements

• Occupations that require heavy lifting or overhead work, such as assembly-line work

• Increasing age

• Rheumatoid arthritis or gout

• Diabetes

You may not want to give up your favorite pastime or your job, but there are other ways you can lower your risk of developing shoulder bursitis.

• Use proper technique and safety gear during sports and exercise

• Use a wheeled cart to carry heavy loads

• Take regular breaks between doing repetitive tasks

• Do warm-up stretching before and after repetitive, vigorous activities

• Exercise to strengthen your shoulder muscles and protect the joint

The goal of treating shoulder bursitis is to reduce inflammation and control pain. Rest and avoiding activities that aggravate shoulder bursitis helps prevent additional injury. Icing the painful shoulder for about 20 to 30 minutes, two or three times a day, helps reduce swelling. Nonsteroidal anti-inflammatory drugs—both oral and topical creams—help reduce pain and inflammation.

Your doctor might recommend using an elastic band or brace to limit movement and protect the joint. If over-the-counter anti-inflammatory medications do not control your pain, your doctor might suggest corticosteroid injections, although this treatment should be reserved until after you’ve tried all other nonsurgical options without success.

Infected shoulder bursitis requires immediate medical care to avoid having the infection spread. If you have fever or chills along with excessive warmth and swelling in your shoulder, seek immediate medical attention. Your doctor will need to drain the swollen bursa of fluid and blood to diagnose the infection, and prescribe antibiotics to treat the infection.

Your doctor may recommend physical therapy to stretch and strengthen the shoulder area. Surgical treatment for shoulder bursitis is uncommon, but it may be necessary if chronic bursitis does not get better with nonsurgical therapies.

Most of the time, shoulder bursitis can be managed with nonsurgical self-care, although it could take you several weeks or even months to completely recover. Left untreated shoulder bursitis complications could arise including increased pain, difficulty moving the joint, limited range of motion, and shoulder tendinitis (inflammation of the shoulder tendon). Eventually these complications can interfere with your daily activities.

If you have infectious bursitis, the infection could lead to sepsis, which is a life-threatening condition. It requires immediate medical treatment.