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Shoulder Bursitis
A bursa is a small fluid-filled cushion that lets tendons glide over bone. The one in the shoulder sits under the bony point at the top, and when it becomes irritated it can be sharply painful and make sleeping on that side impossible. It rarely occurs in isolation — there is usually a cuff problem underneath, which is why treating the bursa alone tends to disappoint.
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Does this sound like you?
Most people have several of these, not all of them.
- Sharp pain at the outside of the shoulder on lifting the arm
- Marked night pain, particularly lying on that side
- Pain that can feel disproportionate to the activity that caused it
- Tenderness to press just under the bony point of the shoulder
- A sense of the shoulder being hot or swollen inside
Why it happens
- Compression from repeated overhead activity
- An underlying rotator cuff tendinopathy irritating the bursa above it
- A direct fall onto the shoulder
- A sudden increase in load the shoulder was not ready for
- Inflammatory conditions such as rheumatoid arthritis
What we would do about it
Roughly in this order — each step waits for the one before it.
- Settling the irritation with load modification and manual therapy
- Treating the cuff underneath, which is usually the actual driver
- Progressive strengthening once the acute pain has eased
- Sleep position and pillow advice for the night pain
- Referral for a cortisone injection where pain is blocking all rehabilitation
- Return to overhead load in graded stages
See a doctor first if
- Your pain followed a significant injury
- It is getting worse rather than settling
- It comes with numbness, weakness or unexplained weight loss
This page is general information, not a diagnosis. Symptoms overlap between conditions, so the right treatment depends on an assessment.
Treating the bursa alone rarely holds
An injection can settle the pain, but if the cuff underneath has not changed it usually returns. We treat both, in the right order. Ask a question first, or call us on 0403 907 587.
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Other shoulder conditions we treat
Related reading: the cuff problem usually underneath it, pinching on reaching overhead and the same pattern at the hip.
General information only, not advice about your own problem — nothing here replaces an assessment. Source: Shoulder Bursitis on Physiopedia.
