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Shoulder Tendonitis/Bursitis

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  • What is Shoulder Tendonitis/Bursitis?

    The terms shoulder tendonitis and shoulder bursitis are often used to indicate that there is inflammation within the shoulder joint, either to the tendons of the rotator cuff or the bursa, the fluid filled sac surrounding the tendons. As the tendons and bursa become inflamed, they thicken and it becomes more difficult to move the shoulder joint without pain and stiffness.  The cause and symptoms of these conditions are the same as those of shoulder impingement, since they are caused by an impingement of some kind within the shoulder joint.


    What causes Shoulder Tendonitis/Bursitis?

    Shoulder tendonitis or bursitis is often caused by repetitive overhead activities, such as those found in some sports (swimming, tennis, baseball) or occupations (painting, construction).  The condition, however, can be caused by anything that causes impingement in the shoulder joint, such as a bone spur or direct injury to the shoulder.  Other conditions such as arthritis, gout, infection or diabetes may also cause inflammation.  The conditions are more likely to occur as a person ages, since the tendons become less flexible and more prone to inflammation.  


    What are the symptoms of Shoulder Tendonitis/Bursitis?

    The main symptom of shoulder tendonitis or bursitis is pain.  The pain may be felt when the arm is raised overhead or outstretched.  Pain may also be felt while sleeping.  The pain is located on the front of the shoulder and upper arm.  Swelling and tenderness will accompany the condition.  As the condition worsens, pain may be felt all day and range of motion may become limited due to inflammation within the shoulder joint and stiffness.


    How is Shoulder Tendonitis/Bursitis diagnosed?

    A medical professional will take a complete medical history and will perform a physical exam.  Questions will be asked related to when the symptoms began, what activities caused the symptoms, what worsens or relieves symptoms, and the relative severity of symptoms.  A physical exam will involve various movements of the arm and shoulder to test for flexibility, mobility, strength, tenderness, inflammation and pain.  X-rays may be used to check for bone spurs or conditions involving the bones of the upper arm or shoulder that may cause impingement and therefore inflammation.  An MRI may be used to get a better view of the soft tissue within the shoulder to determine the amount of inflammation and suspected cause.  


    When should I seek care for Shoulder Tendonitis/Bursitis?

    If you experience shoulder pain, tenderness or stiffness that does not go away after a short period of rest, limitation of activities that exacerbate the pain, application of ice, and over the counter nonsteroidal anti-inflammatory medications, you should seek medical advice.  If you lose strength or mobility in your shoulder, pain is severe enough to limit mobility, or inflammation is accompanied by fever, you should seek immediate medical attention.


    What will the treatment for Shoulder Tendonitis/Bursitis consist of?

    Treatment for shoulder tendonitis or bursitis will typically begin with a course of rest, ice, and nonsteroidal anti-inflammatory medications, as well as limiting the activities that cause pain (such as activities that require the arm to be outstretched above the head).  Injections of steroids may be helpful in relieving more severe pain and inflammation.  Physical therapy is also recommended, including stretching and strengthening exercises, and may need to be followed for weeks or months as gradual improvement is made.  If treatment is unsuccessful or the inflammation is severe, surgery may be required to remove the cause of the inflammation.  Following surgery, rehabilitation is required in order to increase strength and improve range of motion.


    Which muscle groups/joints are commonly affected by Shoulder Tendonitis/Bursitis?

    Shoulder tendonitis or bursitis occurs within the shoulder joint around the area of the rotator cuff and the surrounding bursa.  Pain, stiffness and limited mobility may occur in the shoulder or upper arm.


    What type of results should I expect from the treatment of Shoulder Tendonitis/Bursitis?

    Minor cases of shoulder tendonitis or bursitis may clear up with a short course of rest and limited activity along with application of ice and taking over the counter medications.  Steroid injections may help ease the pain in more moderate cases.  Most patients that follow a structured physical therapy program or that elect to have surgery to remove the source of the inflammation and follow surgery with a rehabilitation program will see a complete improvement in symptoms.  Recovery may take a number of months, however.