Dear Tom,

Bursitis is an inflammation of the bursa, which is a sack of tissue that sits between moving parts of the shoulder. The most common bursa to become inflamed is the subacromial bursa. This bursa sits between the rotator cuff tendons and the overlying deltoid muscle and acromion (the bone which is the top part of the shoulder and the top of the shoulder blade). This type usually causes shoulder and upper, outer arm pain. One can also have bursitis in the back area along the shoulder blade as part of a snapping scapula or scapulothoracic bursitis. This type usually causes pain in the upper back and neck region.

When one is diagnosed with bursitis of the shoulder, it is typically the subacromial bursa. This type of bursitis may be caused by heavy lifting, overuse or trauma, although is many cases it develops spontaneously. Acute bursitis usually responds well to equal amounts of rest, ice, and anti-anti-inflammatory medicines. Sometimes bursitis will occur in the setting of another problem in the shoulder such as a rotator cuff tear or an impingement syndrome, where the rotator cuff tendons become entrapped between the acromion and the humerus.

Bursitis alone will frequently resolve spontaneously. When it persists, I would suggest seeing a doctor to make sure you don’t have some type of co-existing problem such as a rotator cuff tear or bone spur and also because there are some additional treatments, such as a cortisone injection, which can hasten recovery. Again x-rays and an MRI may be helpful in evaluating this type of problem and figuring out the best treatment plan.

Best,

Dr. Millett