Bursitis Shoulder Surgery: All You Need to Know
Bursitis is a condition where you have inflammation of the “bursa”. The bursa is a fluid-filled layer of tissue we have in our bodies at different locations. It is found between the skin and a bony prominence. Some examples of this would be the hip where we have a trochanteric bursa, the shoulder where we have the subacromial bursa or the olecranon bursa over the elbow.
With the inflammation that occurs in bursitis, that tissue becomes thickened and inflamed. It produces pain with movement and can limit the activity and movement of the affected area.
What are the signs and symptoms of shoulder bursitis?
Bursitis tends to cause pain with certain movements and can produce an ache or sharp pain in the affected area. The main signs of bursitis in the shoulder are pain and swelling in the top of the arm, warmth, and pain radiating to the back. Occasionally there may be redness over the bursa, which can be painful to the touch.
What causes shoulder bursitis?
Bursitis is most commonly caused by overuse. This can be due to repetitive motion involving the shoulder, such as swimming or weightlifting. However, even normal activities like driving and gardening can sometimes cause bursitis in the shoulder area of older people.
Other causes of shoulder bursitis include:
- falling onto an outstretched arm
- chronic infections like rheumatoid arthritis
- tumors on the bone, tendons, or joints that push against a bursa (called extrinsic compression)
When to see your doctor for shoulder bursitis?
If your pain lasts more than a few days, or if any redness and warmth begin to develop, you should see your doctor for further evaluation.
You should also consult your physician if you experience any of the following:
- Disabling shoulder pain that limits your daily activities
- Persistent pain despite following conservative treatment
- Inflamed shoulder joint
- Presence of a lump at the affected joint
- Fever and chills
This condition can sometimes resolve on its own, but frequently needs treatment to completely resolve the inflammation.
How is shoulder bursitis diagnosed?
During your consultation, your doctor will ask about your complete medical history and perform a physical exam. You may also need to undergo diagnostic tests to confirm the diagnosis, such as:
- Aspiration, which entails the removal of some fluid from the inflamed bursa to rule out infection or gout.
- Laboratory tests to pinpoint the cause of the infection.
- MRI (magnetic resonance imaging) to see the structure, appearance, and severity of the condition.
- Ultrasound to visualize the inflammation.
- X-ray to rule out arthritis and other musculoskeletal disorders.
What is the treatment for shoulder bursitis?
The goal of treatment is to reduce inflammation and manage pain. In most cases, it is not a serious condition and does not need surgery. It usually gets better within a few weeks or months of conservative treatment.
Bursitis symptoms can be relieved by applying an ice pack on the affected shoulder for a few minutes four to five times a day, wrapping an elastic bandage with heat over your shoulder, or resting your arm in a sling.
Anti-inflammatory medications
Patients who have bursitis often experience significant inflammation in their joints that is usually accompanied by pain and discomfort. Taking anti-inflammatory medications, such as Advil or Motrin, to reduce inflammation may help improve joint mobility and prevent the development of chronic bursitis.
Cortisone injections, or steroid shots, directly into the swollen area can reduce swelling and provide temporary relief from pain. However, cortisone may weaken your tendons, so it’s not advisable to get repeat doses.
Once the pain has diminished, patients may now perform simple exercises or undergo physical therapy to help them return gradually to normal activities.
Physical Therapy
There are different physical therapy that can be used to help minimize pain and inflammation in the joint and strengthen surrounding muscles. This includes ice therapy, stretching exercises as well as heat therapy. Massage therapy may also be used to relax tight muscles.
Do you need surgery for bursitis of the shoulder?
Surgery is usually the last resort when medications and physical therapy fail to improve the symptoms. This is an option when your bursitis is chronic, severe, related to shoulder impingement, or if there is a concern about the stability of your shoulder joint.
According to our shoulder surgeon in Miami, there are three types of surgery for bursitis of the shoulder. The best type of surgery varies per patient and depends on the signs and symptoms and underlying cause.
Bursectomy
A bursectomy is a procedure that removes the inflamed bursa. After which, a new bursa may form.
One main advantage of bursectomy is that it may alleviate the pain and inflammation by eliminating the inflamed bursa. This can decrease long-term reliance on anti-inflammatory medications, physical therapy, and time off work or school for someone suffering from bursitis. Another advantage of bursectomy is that it can minimize future surgery by removing only the affected area surgically.
Acromioplasty or Subacromial Decompression
This surgery may be recommended if the patient has a curved or hook-shaped acromion, which increases the risk of developing shoulder impingement.
During this procedure, the surgeon removes or shaves down part of the shoulder blade’s acromion to create more space for the shoulder’s soft tissues, including the rotator cuff, tendons, and subacromial bursa. By giving these structures more space, they are less likely to become irritated and inflamed.
Muscle and tendon repair
This is recommended if the shoulder bursitis occurred as a result of a torn rotator cuff. The torn muscles and/or tendons are repaired and sewn back.
Depending on the severity of the condition, you may need to follow up with physical therapy afterwards in order to get back to full strength before returning to your usual activities.
What is recovery like?
Recovery from bursitis depends on the severity of your injury. For minor cases that only require rest and anti-inflammatory treatments, it usually takes about 4 weeks (or less) before healing occurs.
For more severe cases that require injections or surgery, recovery can take a bit longer. Recovery times often vary from patient to patient and are dependent on how well you follow and adhere to the treatment plan.
A physical therapist can help design a program to meet your needs in order to help the shoulder heal properly while encouraging the return of your full range of motion. Be sure to check with your shoulder surgeon in our Miami clinic before starting any new activities or getting involved in sports. Until you are fully healed and have regained strength, it’s best to take it easy to prevent further injuries.
Exercises for shoulder bursitis
For those suffering from inflammation or irritation of their bursa, there are specific exercises that may be performed to help alleviate the pain and minimize the build-up of fluid in the joint. You can perform gentle stretches and arm exercises to improve mobility of your shoulders.
Flexibility exercises for shoulder bursitis
Stretching exercises are particularly helpful because they restore flexibility and range of motion that is typically limited or restricted due to chronic inflammation. The following stretching exercises may be beneficial:
- Push your arms straight out towards the sides at shoulder height, then slowly lower them down toward the hips. Hold these for 10 seconds, then repeat the exercise 10 times.
- With the hands clasped together, gently stretch them straight out in front of you while bending at the waist and looking down toward the floor. Slowly extend your arms out to your sides as far as possible without pain or discomfort.
Strengthening exercises for shoulder bursitis
Strengthening exercises are helpful because they build up muscle to support and protect joints from injury. This includes shoulder bursitis. It is important not to overdo it when performing exercises as they should be done gradually, with care taken not to cause further injury or aggravate symptoms.
- Using a wall for assistance, slowly raise your arms until they are in line with the shoulders. Hold for 10 seconds and return to the starting position.
- Extend one arm out in front of you as high as possible while keeping the elbow straight. Slowly lower back down, then repeat on the other side five times.
Frequently asked questions about shoulder bursitis
How painful is bursitis of the shoulder?
Bursitis can be painful in different ways. One of the most common pain symptoms is shoulder stiffness. In other cases, a person may feel general tenderness in their shoulder and arm. The pain can also radiate to the neck, chest or back.
The more severe case of bursitis can lead to some limitations in movement. Patients may find themselves unable to lift their arm overhead or extend it behind their back due to inflammation and swelling. This means they may be unable to reach for things or perform simple activities like putting on some clothes without feeling pain.
What are the risk factors for shoulder bursitis?
- Overuse. The most common risk factor for bursitis in the shoulder is overuse. This means that a person has applied too much pressure to their shoulder joint and surrounding tendons and ligaments. It can result from repetitive activities such as throwing, lifting, or pushing objects.
For example: A person who plays baseball may develop inflammation around their rotator cuff and shoulder joint if they throw hundreds of pitches over a season without giving their arm enough rest between performances.
- Injury or trauma. Sometimes our sports medicine doctor in Miami finds cases of bursitis that are caused by an injury. This is because some parts of the body are connected through muscles and tissues which allow one part to affect another.
For example: if a person falls while playing basketball and lands on their arm, they may be at risk for developing inflammation of the bursa around their shoulder.
What is the difference between shoulder bursitis and shoulder impingement?
Shoulder bursitis is an inflammatory condition that develops in the area of the bursa. The inflammation is usually caused by a direct blow to the shoulder or repetitive movements of the arm and shoulder.
On the other hand, shoulder impingement occurs when the structures in and around the shoulder get pinched. It is one of the most common shoulder injuries and is usually caused by overuse injury and wear-and-tear.
How to prevent shoulder bursitis?
Our orthopedic doctors recommend the following tips to prevent shoulder bursitis:
- Never skip your warm-up and cool-down exercises.
- Take short rests when doing tasks that include repetitive shoulder movement.
- Pick up the pace and intensity of your training gradually.
- Stop activities that cause shoulder pain.
- Incorporate protein-rich foods into your diet.
- Ensure that you are adequately hydrated.
The best way to reduce the risk for bursitis is to have a medical examination if you are experiencing any signs and symptoms.
Where to get surgery for bursitis of the shoulder?
If your shoulder bursitis fails to respond to medication and exercise, we urge you to consult our shoulder surgeon at South Florida orthopedics to know your treatment options.
We have highly-rated orthopedic surgeons who specialize in minimally invasive surgery and the latest innovative non-surgical treatments for conditions affecting the shoulder. Our goal is to provide you with high-level care that is individually fitted to your needs and lifestyle. We offer a variety of surgical, non-surgical and regenerative treatment options, including PRP injection for our patients.
To learn more about our services, please make an appointment.
The material contained on this site is for informational purposes only and DOES NOT CONSTITUTE THE PROVIDING OF MEDICAL ADVICE, and is not intended to be a substitute for independent professional medical judgment, advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare providers with any questions or concerns you may have regarding your health.
