In this article, you will find out everything you need to know about shoulder arthritis and the most effective ways to treat it, including an advanced treatment called Prolotherapy.

Understanding Shoulder Arthritis and Bursitis

What is Shoulder Bursitis?

Shoulder bursitis, also known as subacromial bursitis, occurs when the bursa — a small, fluid-filled sac that cushions the rotator cuff tendons — becomes inflamed. This happens in the narrow space between the shoulder blade and the upper arm bone.

The shoulder joint is formed by three bones: the upper arm bone (humerus), the shoulder blade (scapula), and the collar bone (clavicle). It is a ball-and-socket joint, with the glenohumeral joint being the main articulation where the humeral head (the ball) fits into the shoulder socket (glenoid cavity) of the shoulder blade.

Normally, tendons glide smoothly in this space, but when it becomes too tight, irritation and swelling occur. This leads to inflammation and pain, a condition often linked with shoulder impingement syndrome (Cedars-Sinai, 2019).

What Causes Shoulder Bursitis and Rotator Cuff Problems?

The most common cause of shoulder bursitis is injury or repetitive strain. However, infections and underlying medical conditions like arthritis, gout, diabetes, and thyroid disorders, including chronic diseases such as rheumatoid arthritis, which is a type of inflammatory arthritis caused by the immune system attacking normal tissue in the joints, may also contribute. People with naturally narrower bone structures in the shoulder are more likely to experience bursitis. Even minor thickening of tendons or bursae in these individuals can cause significant pain (Cedars-Sinai, 2019).

What are the Symptoms of Shoulder Bursitis?

Shoulder bursitis often starts after an injury but can worsen over time. The inflamed bursa and tendons may thicken, consuming more space and further compressing the tissues. Pain is the most common symptom of shoulder bursitis. Common symptoms include:

• Persistent shoulder pain, especially when lifting or reaching overhead.
• Swelling and tenderness around the shoulder joint, causing pain and limited movement.
• Limited range of motion.
• Discomfort at night or when lying on the affected side.
• Some patients may notice a grinding sensation in the shoulder during movement.

It is important to note that some people may have few symptoms despite significant inflammation.

How is Shoulder Bursitis Diagnosed?

Diagnosis typically involves a medical history review and a physical exam, which plays a key role in assessing symptoms such as tenderness, pain, and joint changes. Additional tests may include:

• X-ray: Helps rule out other causes such as bone spurs or arthritis, and can reveal narrowing of the joint space, which is a sign of arthritis.
• MRI: Provides detailed imaging of soft tissues including tendons and bursae.
• Ultrasound: Visualizes inflammation in real time.
• Aspiration: Involves extracting fluid from the bursa to check for infection or gout.
• Blood tests: Can identify underlying conditions contributing to inflammation.

Managing Arthritic Conditions

Effectively managing arthritic conditions such as osteoarthritis of the shoulder requires a comprehensive and proactive approach. The primary goals are to manage pain, preserve joint mobility, and slow the progression of joint degeneration. Incorporating physical therapy into your routine is essential, as it helps maintain flexibility and strengthen the muscles that support the shoulder joint. Gentle stretching and light resistance exercises can improve function and reduce discomfort, but it’s important to avoid movements that place excessive strain on the shoulder, which could worsen symptoms. Lifestyle modifications, such as maintaining a healthy weight and using proper body mechanics during daily activities, can also help manage pain and protect the shoulder joint. Working closely with a healthcare provider ensures that your treatment plan is tailored to your specific needs, allowing you to manage shoulder osteoarthritis more effectively and maintain an active, pain-free lifestyle.

Shoulder Osteoarthritis and Bursitis

Shoulder osteoarthritis and bursitis often go hand in hand, creating a cycle of pain and limited mobility in the shoulder joint. Osteoarthritis of the shoulder is a degenerative joint disease that wears away the smooth cartilage covering the joint surfaces, leading to increased friction and discomfort. As the cartilage deteriorates, the underlying bone may become exposed, causing further irritation and inflammation. This process can also affect the rotator cuff tendons and the subacromial bursa, a fluid-filled sac that cushions the space between the shoulder blade and the rotator cuff. When the bursa becomes inflamed, bursitis develops, compounding the pain and stiffness already present from osteoarthritis. Treatment typically begins with non-surgical options such as physical therapy, pain relief medications, and steroid injections to reduce inflammation and relieve pain. In cases where these measures are not sufficient, surgical treatment—including shoulder replacement or shoulder replacement surgery—may be considered to restore joint function and improve quality of life. By addressing both the degenerative changes in the joint and the inflammation of the soft tissues, patients can achieve better pain control and improved shoulder mobility.

Pain Relief and Treatment Options for Shoulder Bursitis

Non-Surgical Treatments

The initial focus is to reduce swelling and inflammation. Patients are advised to avoid painful activities such as overhead reaching. Anti-inflammatory medications (e.g., ibuprofen, naproxen) help reduce pain and swelling. Physical therapy, ice application, and gentle exercises can aid recovery and help restore movement in the shoulder. If symptoms persist, corticosteroid injections may be recommended. These injections provide powerful anti-inflammatory relief but must be used cautiously due to potential tendon weakening (Cedars-Sinai, 2019).

Surgical Treatments

In severe or chronic cases, shoulder surgery may be required. Arthroscopic surgery involves a small incision through which an arthroscope removes inflamed tissue, bone spurs, and can target the ac joint (acromioclavicular joint) or the shoulder socket to enlarge the space and reduce impingement (Cedars-Sinai, 2019).

Prolotherapy

In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat shoulder arthritis.

Published research has proven its pain-relieving, anti-inflammatory and regenerative benefits.

Prolotherapy involves injecting a natural regenerative solution with tiny needles. This has been shown to stimulate the production of collagen cells, the small cells needed to repair the damage and help shoulder arthritis.

As prolotherapy is helping to treat the root cause of shoulder arthritis, it is deemed to be a permanent fix, preventing the symptoms from returning.

Complications and Risks

If left untreated or poorly managed, shoulder arthritis—especially osteoarthritis of the shoulder—can lead to a range of complications that impact daily life. One of the most common issues is the formation of bone spurs, which are bony projections that develop along the edges of the joint and can cause severe pain and restrict joint movement. As the condition progresses, patients may experience a significant reduction in range of motion, making it difficult to perform routine activities. The ongoing stress and inflammation can also weaken the rotator cuff, increasing the risk of a torn rotator cuff or even a broken bone if a fall occurs. These complications not only cause additional pain but can also lead to long-term disability if not addressed promptly. Early intervention and consistent management are crucial to minimizing these risks. By working with a healthcare provider to monitor symptoms and adjust treatment as needed, patients can help preserve joint function, reduce pain, and maintain their independence.

What Can a Physical Therapist Do to Help?

A physical therapist will create a personalized rehabilitation plan to restore strength, flexibility, and mobility. Treatment may include:

• Targeted exercises to improve flexibility and range of motion.
• Posture correction to reduce strain on the shoulder.
• Strengthening programs for rotator cuff and supporting muscles.
• Pain relief techniques such as heat, cold therapy, ultrasound, or electrical stimulation.

With adherence to a structured therapy plan, patients often see improvements within 2–8 weeks (APTA, 2015).

FAQs about Shoulder Bursitis

How long does shoulder bursitis take to heal?

Mild cases can improve in 2–4 weeks with rest and therapy, while chronic cases may take several months.

Can shoulder bursitis heal without treatment?

In some mild cases, bursitis may resolve with rest and activity modification. However, untreated bursitis can become chronic.

Is prolotherapy safe for shoulder bursitis?

Yes, prolotherapy is considered safe when performed by an experienced practitioner. It stimulates natural healing without major risks.

When should I see a doctor?

Seek medical attention if you experience severe pain, significant swelling, fever (possible infection), or if symptoms persist despite rest and therapy. Unexplained weight loss or night time sweating may also be signs of a more serious condition and should prompt medical evaluation.

Contact ProHealth Clinic Today for Your FREE 15-Minute Discovery Call

Don’t let shoulder bursitis control your life any longer. Join the thousands of patients who have found lasting relief through prolotherapy at ProHealth Clinic.

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Email: info@prohealthclinic.co.uk

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Author Bio

Having performed over 10,000 procedures, Mr. Oliver Eaton is one of the UK’s leading practitioners in the treatment of shoulder bursitis, with patients travelling from across the UK, Europe, and the Middle East.

With over 12 years of clinical experience, Oliver is dedicated to helping patients understand their symptoms and providing effective treatment options. He trained in Prolozone Therapy and Prolotherapy in America with the American Academy of Ozonotherapy, and furthered his expertise at the Royal Society of Medicine, Charing Cross Hospital in London, Keele University’s Anatomy & Surgical Training Centre, and Heidelberg University in Germany.

Oliver has had the privilege of treating elite-level athletes, including Olympic and Commonwealth medallists.
Connect with Oliver on LinkedIn.

References

Bursitis of the Shoulder | Cedars-Sinai. (2019). Cedars-Sinai.org

Bursitis Shoulder Pain: Symptoms, Treatment, and Exercises. (2017). Healthline. Healthline

Physical Therapy Guide to Shoulder Bursitis. (2015). American Physical Therapy Association. ChoosePT