Shoulder Tendinitis and Bursitis

Your shoulder is made up of three bones: your humerus (upper arm bone), your clavicle (collarbone), and your scapula (shoulder blade).

The head of your humerus fits into the rounded socket of your scapula. This socket is called the glenoid. A combination of muscles and tendons called the rotator cuff keeps the humeral head centered in the glenoid. The rotator cuff tendons cover the humeral head and attach it to your shoulder blade.

Bursae are small, fluid-filled sacs that are located in joints throughout the body, including the shoulder. They act as cushions between bones and the overlying soft tissues and help reduce friction between the gliding muscles and the bone.

Tendinitis is irritation or inflammation of the tendon, the cord-like tissue that connects muscle to bone. The rotator cuff tendons (particularly the supraspinatus tendon) and the biceps tendon are the main culprits of tendinitis in the shoulder.

Tendinitis of two of the rotator cuff tendons

Generally, tendinitis is one of two types:

• Acute. Repetitive overhead activities during work or sport can lead to the sudden onset of inflammation of the tendon.
• Chronic. Degenerative diseases like arthritis or repetitive wear and tear due to age can lead to chronic tendinitis.

Bursitis is inflammation of the bursa, a small, fluid-filled sac that cushions and reduces friction between the surfaces of a bone and soft tissue as they glide against each other. Repetitive use of the shoulder sometimes leads to inflammation and swelling of the subacromial bursa, which sits immediately above the rotator cuff.

When the subacromial bursa becomes inflamed (subacromial bursitis), this can lead to severe pain and dysfunction of the shoulder and can frequently mimic the symptoms of a rotator cuff tear. Bursitis often occurs in association with rotator cuff tendinitis and both can make daily activities, such as combing your hair or getting dressed, painful and difficult.

If you have any of the following symptoms and suspect that you may have shoulder tendinitis and/or bursitis, call Dr. Jurek for a consultation:

• Shoulder pain or trouble moving that affects your regular daily activities
• Pain doesn’t get better or gets worse with physical therapy

While both arthritis and bursitis affect the joints, arthritis results from wear and tear on the cartilage covering the outside of the bone, and the damage is permanent. Bursitis, on the other hand, is inflammation that can be present for years but does not necessarily cause long-lasting structural damage to the tendon.

Dr. Jurek will conduct a thorough evaluation to determine the cause of your shoulder pain and provide you with treatment options.

Dr. Jurek will ask how and when your shoulder pain started, whether it has occurred before and how it was treated, as well as other questions to help determine your general health and the possible causes of your shoulder problem. Your history can be one of the most valuable tools in finding the source of your pain.

Treatment goals for shoulder tendinitis and bursitis include reduction of pain and inflammation, preservation of mobility, prevention of disability, and avoidance of recurrence.

Over 90 percent of patients with shoulder pain due to tendinitis and/or bursitis respond to simple treatment methods such as rest, activity modification, cold therapy, physical therapy or home exercises, medication, and cortisone injections.

Surgery is sometimes needed to treat shoulder bursitis and tendinitis. Surgery can involve shoulder arthroscopy to smooth rough, inflamed tendon(s) or to remove inflamed bursal tissue.