In this article, you will find out everything you need to know about shoulder bursitis and the most effective ways to treat it, including an advanced treatment called Prolotherapy.
What is Shoulder Bursitis?
Shoulder bursitis, also known as subacromial bursitis, develops when the bursa—a fluid filled sac called the bursa that cushions the tendons of the rotator cuff—becomes inflamed. The bursa helps reduce friction and allows the tendons to slide effortlessly within the subacromial space. Normally, the bursa allows the tendons to glide smoothly under the acromion (the tip of the shoulder blade). However, when inflammation occurs in the subacromial space, this space narrows, and people can develop bursitis, creating painful friction between bones, tendons, and the bursa. This condition is closely linked with shoulder impingement syndrome(Cedars-Sinai, 2019).
What Causes Shoulder Bursitis?
The most common causes and common causes of bursitis include injury, overuse, and infection. These factors can lead to inflammation of the bursae, especially in the shoulder region.
Shoulder bursitis is most often triggered by:
- Repetitive shoulder movements or overuse injuries
- Direct trauma to the shoulder
- Minor trauma, such as repeated low-impact injuries, which can accumulate over time and contribute to bursitis
- Infections
- Underlying conditions such as arthritis, gout, diabetes, or thyroid disorders
Pain from shoulder bursitis can sometimes radiate into the upper arm.
Some individuals have naturally narrower spaces in the shoulder joint, which increases the risk of bursitis. Even mild tendon thickening can lead to painful symptoms.
What are the Symptoms of Shoulder Bursitis?
Recognizing bursitis symptoms is important for diagnosis.
Common symptoms include:
- Sharp or aching pain in the shoulder, especially when lifting the arm overhead
- Dull ache that lingers in the shoulder, which may intensify with certain movements
- Swelling and tenderness around the joint
- Reduced range of motion
- Weakness in the affected arm
- Worsening pain at night or when lying on the affected side
Shoulder bursitis is a painful condition, and pain is often triggered or worsened by certain movements, especially those involving lifting or rotating the arm.
Chronic bursitis can cause persistent inflammation, tendon thickening, and long-term discomfort. Symptoms of bursitis can persist and affect daily activities.
How is Shoulder Bursitis Diagnosed?
Diagnosis begins with a detailed medical history and physical exam. Common diagnostic tests include:
- X-ray: To rule out bone spurs or arthritis and assess bone structures.
- MRI: Provides detailed images of soft tissues including the bursa and tendons. MRI is especially useful in cases of shoulder dislocation to assess joint structures such as the labrum and cartilage.
- Ultrasound: Detects bursal inflammation in real time.
- Aspiration: Fluid removal from the bursa to test for infection or gout.
- Blood tests: Helps identify related conditions such as autoimmune disorders.
In complex or persistent cases, referral to an orthopedic surgeon may be necessary for further evaluation and management.
Complications and Related Conditions
If shoulder bursitis is not properly managed, it can lead to a range of complications that may impact your long-term shoulder health. Chronic bursitis can cause lasting damage to the bursae, resulting in persistent pain, stiffness, and a reduced range of motion in the shoulder joint. Over time, ongoing inflammation may weaken the rotator cuff, increasing the risk of rotator cuff tears—an injury that often requires more intensive treatment or even surgery.
Certain medical conditions can also make you more susceptible to developing bursitis. People with rheumatoid arthritis, inflammatory arthritis, or thyroid disease are at a higher risk due to the underlying inflammation these conditions cause in the joints. If you notice that your symptoms are not improving or are getting worse, it’s important to consult a healthcare provider. Early intervention can help prevent permanent injury to the rotator cuff and shoulder joint, preserving your mobility and quality of life.
Treatment Options for Shoulder Bursitis
Non-Surgical Treatments
The primary goal is reducing inflammation and restoring mobility:
- Avoiding painful activities (lifting overhead or repetitive motion).
- Applying ice packs for 15–20 minutes every few hours in the early stages.
- Over-the-counter anti-inflammatory medications (e.g., ibuprofen, naproxen).
- Physiotherapy to restore range of motion and strengthen surrounding muscles, including targeted exercises for the arms, shoulders, and shoulder blades. These may involve stretching the arms, performing shoulder blade squeezes, and strengthening the shoulders. Proper positioning of the elbow and maintaining correct alignment of the elbows during exercises is essential for effective rehabilitation and to prevent further injury.
If pain persists, doctors may recommend corticosteroid injections. These injections reduce swelling but should be used cautiously, as repeated use can weaken tendons (Cedars-Sinai, 2019).
Surgical Treatment
In severe or persistent cases, a procedure known as shoulder bursitis surgery—typically performed arthroscopically—may be used to remove the inflamed bursa, smooth bone surfaces, and create more space for the rotator cuff tendons. This procedure is minimally invasive and has a relatively quick recovery time.
Prolotherapy
In recent years, Prolotherapy has built its reputation within the medical community for its clinically proven ability to treat shoulder bursitis.
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 bursitis.
As prolotherapy is helping to treat the root cause of shoulder bursitis, it is deemed to be a permanent fix, preventing the symptoms from returning.
Managing Pain and Inflammation
Effectively managing pain and inflammation is a key part of treating shoulder bursitis and restoring function to the affected area. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used to reduce pain and swelling, while corticosteroid injections may be recommended for more severe inflammation. These treatments can provide significant relief, especially when combined with physical therapy designed to improve range of motion and strengthen the shoulder.
Applying an ice pack to the shoulder for 15–20 minutes at a time can help decrease inflammation and soothe discomfort, particularly after activity. It’s also important to rest the shoulder and avoid repetitive movements that could aggravate the inflamed bursa. Working closely with your healthcare provider ensures that your treatment plan is tailored to your specific needs, helping you manage pain and inflammation effectively while supporting a safe and steady recovery.
What Can a Physical Therapist Do to Help?
Physical therapists play a crucial role in recovery. Treatment may include:
- Pain and Inflammation Reduction: Using modalities like ultrasound, ice, electrical stimulation, and taping.
- Improving Mobility: Gentle guided exercises to restore range of motion, such as moving the hand across the body to the opposite side to improve shoulder rotation.
- Stretching and Flexibility: Addressing stiffness in the shoulder, neck, or chest muscles.
- Posture Correction: Training to reduce stress on the shoulder.
- Strengthening: Gradual resistance training using bands, weights, or bodyweight exercises.
- Endurance Building: Cardiovascular and upper-body conditioning to support recovery.
- Home Exercise Programs: Tailored routines for long-term maintenance.
With consistent physiotherapy, most patients recover within 2 to 8 weeks (American Physical Therapy Association, 2015).
Preventing Future Episodes
Taking steps to prevent future episodes of shoulder bursitis is essential for maintaining a healthy, pain-free shoulder. One of the most effective strategies is to strengthen the rotator cuff muscles, which support the shoulder joint and help reduce the risk of injury. Incorporating regular exercises and stretches into your routine can improve joint stability and flexibility.
Maintaining a healthy weight also reduces stress on the shoulder, while avoiding repetitive movements and overhead activities can help protect the joint from overuse. If your daily activities involve lifting or repetitive arm motions, be sure to use proper techniques and take frequent breaks to rest and stretch your shoulder. By making these lifestyle adjustments, you can significantly lower your chances of developing bursitis and keep your shoulder functioning at its best.
Frequently Asked Questions
Can shoulder bursitis heal on its own?
Mild cases often improve with rest, ice, and anti-inflammatory medication. Chronic bursitis, however, usually requires physiotherapy or medical treatment.
How long does it take to recover from shoulder bursitis?
Recovery time varies. Many patients improve within weeks, but severe or chronic cases can take several months.
Is shoulder bursitis the same as shoulder impingement?
They are closely related. Impingement occurs when structures in the shoulder joint rub together, often causing bursitis.
When should I see a doctor for shoulder bursitis?
If pain persists beyond two weeks, disrupts sleep, or limits daily activities, medical evaluation is recommended.
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.
Get in Touch
Phone: +441234380345
Email: info@prohealthclinic.co.uk
Our Clinic Locations
London: 104 Harley Street, Marylebone, W1G 7JD
Manchester: The Hadley Clinic, 64 Bridge Street, M3 3BN
Bedford: The Village Medical Centre, Kingswood Way, MK40 4GH
All clinics offer the same award-winning prolotherapy treatment with convenient appointment times, including evenings and weekends.
Author Bio
Having performed over 10,000 procedures, Mr Oliver Eaton is one of the UK’s leading practitioners in the field of treating shoulder bursitis, with patients travelling to see him 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 associated with shoulder bursitis and providing effective treatment options. He qualified in Prolozone Therapy and Prolotherapy with the American Academy of Ozonotherapy and continued advanced training at the Royal Society of Medicine, Charing Cross Hospital (London), Keele University’s Anatomy & Surgical Training Centre, and Heidelberg University in Germany. Over the years, he has treated many elite-level athletes, including Olympic and Commonwealth medallists.
LinkedIn profile: Oliver Eaton
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