Shoulder Bursitis
Shoulder bursitis rarely happens on its own, it usually points to something being pinched or overloaded. Assessment to find the real driver of the pain and treatment to settle it properly.
- Certified Hand Therapist (CHT)
- Consultant Hand Therapist
- Hand, wrist & upper limb specialist
What is Shoulder Bursitis?
Shoulder bursitis, most commonly subacromial bursitis, is inflammation of the bursa: a fluid-filled sac situated in the shoulder joint. The bursa normally reduces friction during shoulder movement, but when it becomes inflamed it swells and becomes painful.
Shoulder bursitis rarely occurs in isolation. It most frequently coexists with rotator cuff tendinopathy and together they form the shoulder impingement syndrome, a spectrum of conditions affecting the structures within the subacromial space. Accurate assessment is important to identify all contributing factors. Specialist Hand Therapy addresses both the bursitis and the underlying biomechanical drivers.
What you might notice
- Shoulder and upper arm pain
- Pain and difficulty with overhead activities and reaching across the body
- Night pain, particularly when lying on the affected shoulder
Why it happens
- Repetitive overhead activities producing shoulder impingement: painting, swimming, throwing
- Poor shoulder biomechanics
- Rotator cuff weakness
- Acromial morphology: altered shoulder anatomy increasing the risk ofimpingement
- Direct trauma to the shoulder or a fall onto an outstretched arm
- Inflammatory arthritis: rheumatoid arthritis and gout can cause acute shoulder bursitis
How it's treated
After a thorough assessment, a personalised treatment plan is built around your needs and goals.
Ms Razo provides appropriate advice and guidance to reduce undue loading on the inflamed bursa during daily activities.
Targeted therapeutic activities and exercises address the primary biomechanical driver shoulder impingement. Ms Razo designs a graded programme that is regularly reviewed and updated.
Subacromial corticosteroid injection is commonly used to reduce bursal inflammation and create a window for rehabilitation. Ms Razo provides structured rehabilitation following injection once the acute pain response has settled.
Arthroscopic subacromial decompression and bursectomy require specialist post-operative rehabilitation to restore shoulder movement, strength and functional use of the arm. Ms Razo provides a structured, phased programme following these procedures.
Common questions
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Subacromial bursitis and rotator cuff tendinopathy both cause shoulder pain in a similar distribution. They frequently coexist: chronic rotator cuff tendinopathy is associated with secondary bursitis and bursitis can itself cause rotator cuff irritation. Advanced clinical assessment and treatment address both conditions.
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Subacromial corticosteroid injections typically produce significant pain relief within 1–2 weeks. The effect may last weeks to months. Injection alone does not address the underlying cause of the bursitis, which is why structured rehabilitation following injection is important to prevent recurrence. Ms Razo can provide rehabilitation as soon as the post-injection pain response has settled, typically after 1–2 weeks.
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The majority of shoulder bursitis cases resolve with non-operative management including Hand Therapy. Arthroscopic subacromial decompression is considered when all other measures have been exhausted and significant symptoms persist.
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Prolonged shoulder pain from any cause, including bursitis, can lead to secondary stiffening of the shoulder capsule if the arm is guarded and underused over an extended period. This is why active rehabilitation, maintaining shoulder movement and avoiding prolonged protective posturing are important in the management of shoulder bursitis.
Clinically reviewed by Ms Michelle Razo CHT · May 2026