The shoulder joint allows us to do everything from hugging our children to putting groceries in the car. Rather than one joint working in isolation with limited movement, the shoulder enjoys a wide range of motion – the widest of any joint in the body. When shoulder pain strikes, we quickly understand how important (and well-used) the shoulder joint is. Shoulder bursitis is a common ailment for many people, with symptoms ranging from a minor inconvenience to completely debilitating pain. As with the condition itself, shoulder bursitis treatments may be minor (changes to your routine) to more involved (full-blown surgical intervention). Here are nine at-home and advanced interventional shoulder bursitis treatments to consider.
What is shoulder bursitis?
Shoulder bursitis is best understood in the context of shoulder anatomy. Three bones meet to make up the shoulder:
- The humerus (upper arm bone)
- The scapula (shoulder blade)
- The clavicle (collarbones)
The shoulder joint itself is a ball-and-socket joint that is part of the larger anatomy of what is known as the shoulder girdle (or shoulder capsule). This entire structure consists of four joints.
- The shoulder joint: Also called the glenohumeral joint, with a ball-and-socket movement where the humerus fits into the scapula
- The acromioclavicular (AC) joint: The point where the scapula meets the clavicle (this forms what is known as the “roof” of the shoulder)
- The sternoclavicular (SC) joint: The connection between the clavicle and the sternum
- The scapulothoracic joint: The attachment between the scapula and the ribs at the back
The rotator cuff is a group of muscles that surrounds the shoulders, giving it support and allowing it a free range of motion. Ligaments and tendons further stabilize all four joints, attaching muscle to bone (tendons) and bone to bone (ligaments). The cup-like glenohumeral joint receives the humerus and helps it to glide smoothly with a lining of cartilage. Further cushioning and easing your movements are small, fluid-filled sacs called bursa.
With so many moving parts, shoulder injuries and pain are one of the more common upper body pain conditions. Of these, shoulder bursitis, also called rotator cuff tendonitis or impingement syndrome, is arguably the most common. Shoulder bursitis occurs when the bursa become irritated and inflamed. Depending on the severity, this inflammation can completely shut down mobility in your shoulder.
What causes shoulder bursitis?
The most common cause of shoulder bursitis is any activity that involves repetitive motion, especially overhead. Baseball players, tennis pros, and golfers are frequently diagnosed with shoulder bursitis.
If your job requires kneeling or reaching overhead repeatedly (i.e., cleaning floors or hanging drywall), you are at a higher risk for shoulder bursitis as well. Leaning for long periods of time on the elbows can also irritate the bursa and lead to shoulder bursitis.
Finally, injury or trauma to the joint can cause shoulder bursitis. This includes car accidents, falls, or blows to the shoulder in contact sports. In some cases, shoulder bursitis develops some time after the injury occurs, perhaps in response to the healing process or as a result of restricted movement. This is not to be confused with frozen shoulder (a condition that affects the connective tissue in the shoulder, not the bursa.)
Shoulder bursitis can occur in anyone at any age but most commonly affects older adults. People with other health conditions like rheumatoid arthritis, gout, and diabetes are also more at risk.
Do I have shoulder bursitis?
Shoulder bursitis symptoms are typically worse at night after a long day of activity, or in the morning when the shoulder has been still for a long period of time. The most common area for shoulder bursitis is the subacromial bursa. Inflammation in this area causes pain when the arms lift overhead.
Other shoulder bursitis symptoms include:
- Range of motion that is restricted by pain
- Swelling and redness in and around the shoulder joint
- Pain at the tip of the shoulder
- Pain upon contact
In severe cases, pain may be accompanied by fever, which may indicate an infection of the bursa. Infection can become serious and should be treated urgently.
Your doctor will start your shoulder bursitis diagnosis by asking about your medical history and conducting a physical exam. Your doctor will test your range of motion and feel for swelling or warmth that indicates inflammation in the joint.
If, other than pain, there are no other physical symptoms, your doctor may recommend imaging to rule out other causes. X-rays cannot detect inflamed bursa but can verify that there is no damage in the bones. MRIs can see soft and connective tissue and may be able to help with a diagnosis.
In cases where they suspect an infection, your doctor may order blood tests to look for elevated white blood cells that indicate an immune response to infection. If there is fluid on the shoulder, this fluid can also be analyzed to confirm a diagnosis (or rule out other conditions).
Will shoulder bursitis go away on its own?
If nothing changes, shoulder bursitis will, at best, stay the same. When the bursa are inflamed and irritated, continuing with the same activity usually makes the problem worse. This does not mean all movement needs to stop. There are a variety of shoulder bursitis treatments at home and shoulder bursitis exercises that can help ease symptoms and treat pain and inflammation. These are best done after a diagnosis, though, and under the guidance of your doctor.
Regardless of treatment, shoulder bursitis recovery time will vary depending on the severity of your symptoms and any underlying health conditions.
How to treat shoulder bursitis: 9 treatments
At-home shoulder bursitis treatments are often adequate to treat shoulder bursitis symptoms and heal your pain and inflammation. The following five at-home treatments are a great place to start to ease pain while keeping a good range of motion. More interventional techniques are discussed after.
In the acute phase, you should rest your shoulder. This means limiting the activity that lead to the inflammation. Restricting extreme overhead motion (e.g., playing tennis or any activity that has your arms raised overhead) for a few days can give the inflammation a chance to recede.
In some cases, immobilizing the arm completely with a sling may be necessary. Typically, you’ll combine rest with other at-home shoulder bursitis treatments.
Also in the acute phase, ice can help calm inflammation and offer acute pain relief.
Applying ice packs in a 20-minute on, 20-minute off schedule for the first 24 hours may also provide significant (if chilly!) pain relief.
After the first 24 hours, warming pads and hot baths can help keep blood flowing in the shoulder capsule and also provide significant pain relief.
The best medications for shoulder bursitis are usually over-the-counter non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen. These control both pain and inflammation. Even though they are sold over the counter, it is important to take them only as directed.
If an infection is suspected, your doctor may also prescribe antibiotics. Take these as directed as well, making sure to finish the entire course (even when your shoulder begins to feel better).
5. Shoulder bursitis stretches
Once the inflammation and pain subsides somewhat, shoulder bursitis stretches can help restore (and increase) your range of motion for better shoulder health. These are low-impact stretches that can be done every day. You may want to complete these shoulder bursitis exercises for both shoulders to stay balanced in your range of motion. Note: only perform these stretches after getting approval from your doctor.
Stand (or sit in a chair with both feet flat on the ground). On an inhale, lift both shoulders towards your ears and pause at the top of the inhale. Exhale and circle your shoulders back and down, feeling the shoulder blades come together on your back. Repeat five to ten times daily.
Stand with your injured shoulder next to the wall. Bend your elbow at a 90-degree angle. Press the back of the hand against the wall and hold for five seconds. Repeat five to 15 times daily.
Take a strap or a belt between your hands, wider than your shoulders and with your palms facing down. On an inhale, keep your arms straight but raise your arms above your head. Hold for five seconds, then slowly lower. Repeat five to ten times. As your shoulder heals, you can exhale and lower the arms behind the body (making them as wide as needed to keep the arms straight), then inhale to bring them back up and overhead to the front.
Stand facing a wall (the front of your body should be touching the wall). Raise the arm with the injured shoulder with the elbow bent at a 90-degree angle and place it on the wall (palm facing the wall). Slowly begin to turn your body so that the raised arm is flat on the wall, but your body is opening away from the wall. Stop when you feel a good stretch then breathe there for ten breaths. Stretch the other shoulder the same way, then repeat two more times on each side.
Whichever stretches you complete, take your time and be patient with your healing. Moving too quickly or ignoring extreme pain can only prolong the healing process or exacerbate your shoulder bursitis, so proceed with caution.
6. Physical therapy
The best shoulder bursitis treatment approaches combine at-home treatments with further intervention when needed. Here’s what you can expect.
A physical therapist can work with you to correct any underlying mechanical issues that may have caused your inflammation.
This means working to strengthen the muscles that support the shoulder while adding range of motion exercises and proper alignment techniques to support the shoulder and prevent further injury.
7. Chiropractic care
Chiropractic care uses spinal manipulations to safely realign the spine.
This may help address any issues in the shoulder that are caused by misalignment of the vertebrae anywhere along the spine, but especially in the upper portions.
Acupuncture uses the principles of traditional Chinese medicine to clear up blocked channels in the energy meridians of the body.
During this procedure, hair-thin needles are inserted at specific points in the body depending on what condition is being treated. Initial studies show clinically significant decreases in shoulder pain when compared to sham acupuncture treatments.
9. Interventional treatments and surgery
In some cases, joint injections to relieve pain and inflammation may be recommended, but this is not considered a first-line treatment and is generally only utilized when conservative measures have failed. However, for those who are experiencing severe or chronic pain, shoulder injections can help manage their pain while undergoing other treatments like physical therapy.
For extreme and chronic shoulder bursitis that does not resolve after six months of treatment, surgery to drain the bursa (or remove them altogether) may be explored.
If you are looking for shoulder bursitis treatments in Arizona, give the pain specialists at Arizona Pain a call. We can design a personalized treatment plan that will get you back to doing the things you love!
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