What is Bursitis/Tendonitis of the Shoulder?
The body includes 160 bursae, small fluid-filled sacs that serve to reduce friction between tissues. The major bursae are near the large joints, adjacent to the tendons. These joints include hips, knees, elbows and shoulders. Shoulder bursitis is inflammation of the bursa in the shoulder joint.
Shoulder tendonitis is often present with shoulder bursitis. Shoulder tendonitis (also knows as tenosynovitis) affects any of the tendons surrounding the shoulder joint, most commonly the rotator cuff but also possibly the biceps and triceps. It is a degenerative condition of any of these tendons.
The risk of bursitis is greatest after age 40, with the condition affecting 200,000 Americans annually. Tendonitis is more common over age 30, with a similar number of cases as bursitis among Americans annually.
What Are the Causes?
Although it can occur without any specific cause, there are a variety of usual causes of shoulder bursitis and its characteristic inflammation. These include:
- Age (degeneration)
- Autoimmune diseases-rheumatoid arthritis, Psoriatic arthritis, Gout, Thyroid disorders
- Bone spurs or calcium deposits
- Infection (although rare in the shoulder)
- Overuse (e.g. from gardening, carpentry, shoveling, baseball (throwing/pitching), swimming and golf)
- Poor exercise habits (lack of stretching or conditioning prior to activity)
- Poor posture
Shoulder tendonitis occurs due to many of the above causes, but is primarily a result of sports injuries among all levels of athletes, and other overuse activities, such as by those who do overhead work. Trauma that entails a direct blow to the shoulder area can cause tendonitis as well.
What Are the Symptoms?
Bursitis and tendonitis have very similar symptoms. These include:
- Localized pain, swelling, tenderness
- Pain with movement of the shoulder or raising the arm overhead
- Pain that may interrupt sleep by lying on the side/shoulder
- Pain that worsens with reaching, pulling, pushing, lifting
- Restricted movement (severe loss of movement is called “frozen shoulder”)
- Shoulder weakness
- Stiffness and loss of mobility or strength
What Are the Treatment Options?
There are a variety of both lifestyle measures and effective non-surgical solutions for shoulder bursitis/tendonitis. These include:
- Heat – Helps with stiffness and provides flexibility and range of motion
- Ice – Helps with swelling and inflammation
- Non-steroidal anti-inflammatory drugs, or NSAIDs – Includes anti-inflammatory medications, such as ibuprofen, naproxen and cox-2 inhibitors (such as Celebrex) that can both reduce swelling and relieve pain
- Physical therapy – Includes strengthening and stretching exercises to aid the shoulder and to improve posture.
- Rest – Avoid or limit activities that will aggravate an inflamed shoulder bursa or tendons.
- Shoulder injections – These can treat shoulder pain very effectively, and are particularly recommended after other treatments have failed or no longer provide relief. Some people mistakenly believe that these injections are very painful; however, they are usually similar to a common immunization, and often result in little to no discomfort. Also, these injections are not simply pain-killing. They reduce inflammation, specifically in and around the rotator cuff, which does relieve pain, but it also serves to treat the injury. In addition, once the inflammation is reduced, it allows the possibility for other treatments that may have been hampered, such as exercise.
- Topical medications – Creams, gels, sprays and patches applied to the skin of the affected shoulder area.
Is the Condition Reversible?
Shoulder bursitis and tendonitis both respond well to treatment, and recovery can be very good. Mild to moderate shoulder bursitis usually requires two to four weeks to resolve, especially if it is in a younger person and this is a first-time episode. Obviously, for those with particular risk factors or less timely treatment, it can take much longer, perhaps six to eight weeks or even longer.
To prevent further problems, or avoid them in the first place, consider these tips:
- Do strengthening and stretching exercises focused particularly on the shoulder and surrounding area.
- Warm up and stretch before exercise.
- Introduce new physical activity with proper gradual training.
- Exercise regularly; avoid sporadic exercise.
- Practice good posture and body mechanics.
- Practice proper lifting techniques.
- Move around. Avoid sitting or staying in one position for more than 20 to 30 minutes.
- Stop any exercise or other activity that causes pain.
To explore treatments for shoulder pain with a customized evaluation from our pain management specialist, contact Nova Spine & Pain Centers and schedule an appointment today.