Shoulder Pain and Bursitis

B. Eugene Brady, MD
Board Certified Orthopedic Surgeon

Shoulder pain is an extremely common complaint which has many possible causes. In order to best treat the condition, it is important to determine the source of the pain.

Diagnosing shoulder pain.
The most common diagnosis for shoulder pain is shoulder bursitis, a condition characterized by the inflammation of a particular area within the shoulder joint. Specifically, the inflammation occurs in the area between the top of the arm bone and the tip of the shoulder, where the tendons of the rotator cuff are located.

In some individuals with shoulder bursitis, the shape of their bones is such that they have less space in the joint than others, thus increasing their susceptibility. Often, however, there is an injury to the area that sets off the process.

The symptoms of shoulder bursitis
Symptoms of shoulder bursitis include pain with overhead activities, pain while sleeping or lying down, pain that persists beyond a few days, or pain over the outside of the shoulder and upper arm. Because these symptoms are similar to those associated with other shoulder pain issues, it is important that you talk to your doctor to rule out other causes.

Treatment for shoulder bursitis
If you and your doctor determine that your pain is caused by shoulder bursitis, the first method of treatment will most likely be anti-inflammatory medications such as ibuprofen, which reduce the swelling of the tendons and thus lessen the pain in the joint. Resting the joint is also important, as is avoiding activities that irritate the rotator cuff tendons. Once the initial pain subsides, some simple exercises or physical therapy may be suggested to help strengthen the rotator cuff and help the shoulder move more efficiently.

If symptoms are pronounced, your doctor may administer a cortisone injection, or steroid shot, directly into the area of inflammation. Although cortisone shots are considered safe and can work quickly to decrease inflammation and pain, they can also weaken tendons and are to be repeated only after careful consideration.

In rare cases, surgery may be needed to treat shoulder bursitis. Generally, however, the non-surgical treatments we have discussed will begin to work quickly with resolution of symptoms over a period of one to three months.