Shoulder Impingement & Bursitis
Shoulder impingement and bursitis can cause pain, inflammation and difficulty moving the arm comfortably. These conditions often develop when tendons of the rotator cuff and the protective bursa become irritated within the limited space beneath the top of the shoulder.
Understanding Shoulder Impingement
The rotator cuff tendons pass through a narrow space beneath the acromion, a portion of the shoulder blade. When that space becomes crowded or irritated, the tendons and nearby bursa can be compressed during arm movement, creating pain and inflammation.
What Is Shoulder Bursitis?
A bursa is a small fluid-filled sac that reduces friction between moving tissues. In the shoulder, the subacromial bursa helps the rotator cuff glide smoothly. When it becomes irritated or swollen, movement can become increasingly painful.
How Shoulder Impingement & Bursitis May Feel
Symptoms often worsen when the arm is raised overhead or when the affected shoulder is repeatedly used.
Common Symptoms May Include:
Why Does Shoulder Impingement Develop?
Anything that increases inflammation or reduces the amount of space available for the rotator cuff and bursa can contribute to symptoms.
Repetitive Overhead Activity
Repeated reaching, lifting, throwing or overhead work can irritate rotator cuff tendons and the bursa over time.
Shoulder Injury
Falls, direct trauma or sudden overloading of the shoulder can trigger inflammation and make normal movement painful.
Arthritis & Bone Spurs
Degenerative changes around the shoulder can reduce the available space beneath the acromion and contribute to impingement.
Shoulder Mechanics
Muscle weakness, poor posture or altered shoulder-blade movement can change the way the shoulder moves and increase pressure on the rotator cuff.
Who May Be More Likely to Develop Shoulder Bursitis?
Shoulder irritation can affect anyone, but certain medical, occupational and activity-related factors can increase the risk.
Age & Wear
Tendons and joint structures can become more susceptible to irritation and degeneration with age.
Repetitive Occupations
Painting, construction, lifting and other jobs requiring repeated overhead movement can place significant stress on the shoulder.
Sports
Swimming, tennis, baseball, weightlifting and other overhead sports can repeatedly load the rotator cuff and bursa.
Underlying Conditions
Arthritis, gout, diabetes, thyroid disorders and other conditions may increase the likelihood of bursitis or tendon problems.
How Shoulder Impingement & Bursitis Are Diagnosed
Diagnosis typically begins with a physical examination and may include imaging when needed to determine which shoulder structures are contributing to the pain.
Your provider will review when symptoms began, recent injuries and which activities or positions make pain worse.
Shoulder strength, tenderness, range of motion and movements that reproduce impingement symptoms may be assessed.
X-rays, ultrasound or MRI may be used to evaluate the bursa, rotator cuff, bones and other structures when appropriate.
If infection, gout or another inflammatory disorder is suspected, fluid or blood testing may be recommended.
Treating Shoulder Impingement & Bursitis
Treatment usually begins conservatively with the goal of reducing inflammation while restoring healthy shoulder movement and strength.
Physical Therapy
Stretching, rotator cuff strengthening and shoulder-blade stabilization can improve mechanics and help reduce recurrent irritation.
Medication
Anti-inflammatory or other pain medications may be recommended when appropriate to reduce discomfort and inflammation.
Shoulder Injection
A corticosteroid injection into the subacromial space may be considered in selected patients to reduce inflammation and make rehabilitation more comfortable.
Surgical Evaluation
Surgery may be considered when significant structural problems are present or symptoms remain severe despite appropriate conservative treatment.
Inflammation Can Reduce Space — And Reduced Space Can Create More Irritation.
Shoulder impingement can become a cycle: irritated tissue swells, swelling reduces the available space in the shoulder, and movement then creates additional irritation. Treatment focuses on reducing inflammation while restoring strength, flexibility and healthier shoulder mechanics to help break that cycle.
Does Shoulder Pain Make It Difficult to Lift Your Arm?
Schedule a consultation to determine whether bursitis, impingement or another shoulder condition may be causing your symptoms and discuss available treatment options.