When you have bursitis, your bursa becomes inflamed, causing a decrease in the cushioned space, restriction in your shoulder's movement, and pain. When you have tendonitis, the tendons that connect the muscles and bones in your shoulder can become inflamed when your muscles flex and relax, using repetitive motions.
Your doctor can usually differentiate between bursitis and tendinitis based on the location of the pain and swelling in relation to the anatomy of the affected area, but he or she may recommend imaging tests to confirm the diagnosis.
Bursitis is inflammation (swelling, heat) or irritation of a bursa. Bursae are small sacs between bone and other moving parts, such as muscles, skin or tendons. The bursa allows smooth gliding between moving parts. Tendonitis is inflammation or irritation of a tendon.
Initially, the pain is located at the outside of the shoulder at the very top of the arm, but as symptoms progress, the pain may radiate down the outside of the arm (though rarely past the elbow). As the condition gets worse, a person may avoid using the shoulder, causing the muscles to weaken.
Icing and NSAIDs (anti-inflammatory medications) help to reduce swelling. It is also important to compress the bursa with an elastic bandage and use padding upon returning to the activity that initially caused the problem.
The inflammation causes the bursa to swell and grow, leaving less room in the shoulder joint for the muscles and tendons, which results in pain with movement. You may feel pain around the outside and tip of the shoulder, and it may be painful to the touch or red or swollen.
Initially the shoulder tends to be painful only during motion, but this may develop into a constant pain like 'toothache' in the shoulder. it can affect sleep and often patients cannot lie on the affected side.
The most common causes of bursitis are injury or overuse. Infection may also cause it. Bursitis is also associated with other problems. These include arthritis, gout, tendonitis, diabetes, and thyroid disease.
X-ray images can't positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone.
Bursitis usually causes a dull pain, tenderness, and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch.
Tendonitis in the shoulder results when inflammation pinches or traps the tendon against bones. Shoulder tendonitis pain—usually felt at the tip of the shoulder or radiating down the arm—commonly occurs when the arm is lifted overhead or twisted. Symptoms can range from mild stiffness to severe pain.
The pain is mild at first and then gradually worsens as the inflammation continues. In most cases, the pain occurs when you're active and feels better when you rest. But as tendonitis goes untreated and worsens, you may also experience pain when resting.
Shoulder bursitis may take longer to heal if other shoulder problems are present, including tendinitis or bone problems. Bursitis can be chronic when it is caused by medical conditions, particularly rheumatoid arthritis.
It is located below the acromion, the large bony projection on the scapula (shoulder blade). This is why the majority of pain associated with shoulder bursitis occurs at the top and outside of the joint and radiates down the arm.
Massage therapy has been found to be an effective treatment for both acute and chronic cases of shoulder bursitis. In addition to providing relief from pain, massage can also reduce inflammation, increase the range of motion, and improve overall function in the affected area.
If you have bursitis, the affected joint might: Feel achy or stiff. Hurt more when you move it or press on it.
When sleeping with shoulder bursitis, you should avoid sleeping on your front or side. Sleeping on your back is best for this condition, though if you simply cannot get to sleep on your back you can try the side-sleeping positions above.
Generally, bursitis will subside with rest and extra care to protect the joint and limit use. If pain is persistent, you should see a doctor to develop a practical course of treatment.
More serious overuse injuries may require a visit to a shoulder specialist for treatment. Examples include: Painful bursitis, an inflammation of the bursa (the sac that reduces friction around the joint) Shoulder impingement, when the structures of the shoulder pinch or rub painfully against each other.