Don’t shoulder that burden!
Of all the joints in the body, the shoulder is one of the most mobile. In order to reach, grasp and interact with our surroundings, the shoulder must move to get the arm into many different positions. Whether it’s scratching an itch behind the back, reaching into the top shelf, or swinging a racquet, the shoulder needs to move!
However, the downside to having so much movement at the shoulder is that it can end up getting into some uncomfortable positions. One of the most common symptoms reported by patients is a sharp, pinching sensation. This can occur with overhead movements, reaching behind the back, or lifting the arm sideways. Even lying on the painful shoulder can be unpleasant and affect the quality of sleep.
What is shoulder bursitis?
A bursa is a small sac of fluid that is usually located in parts of the body where a lot of movement occurs – like the shoulder! The bursa acts as a cushion and reduces friction within the body, allowing tendons, ligaments and muscles to glide over bones and other structures when we move. Occasionally, the bursa can become irritated and inflamed if there is excessive movement (e.g., through sport or work), leading to bursitis.
What does shoulder bursitis feel like?
As mentioned above, one of the most common symptoms is a painful, pinching sensation with overhead movements or reaching behind the back. There can also be pain lying on the affected shoulder, which may result in waking at night. In some cases, there may be a loss of shoulder movement.
Do I need to get a scan?
That depends! In order to diagnose bursitis, you need to know that there is inflammation of the bursa. An ultrasound or MRI scan are the most common ways of investigating this. However, imaging is not necessary to finding the solution to your shoulder pain. That’s because you are more than just your scans, and the inflammation is only one piece of the puzzle. Sometimes, there are other issues that need to be addressed such as muscular strength or endurance, range of motion deficits, and load management.
If you already have a scan that says you have bursitis, that’s OK! We will inspect the scan and report and discuss this with you, but our priority is to understand your experience of the condition as this will help us tailor treatment specifically to you.
What does treatment involve?
Even though exercising may seem counter-intuitive for shoulder pain, research strongly recommends an exercise-based treatment program. Exercise has been shown to improve shoulder pain in both the short- (<1 month) and long-term (>3 months), and has even shown superior outcomes compared to other types of treatment such as having a cortisone injection (Abdulla et al., 2015).
When it comes to exercise, the tricky part is finding the right ones (and right amounts) for you. Whilst there are plenty of exercise programs available on the Internet, we don’t usually recommend picking one at random, as this may worsen your symptoms. Having your issue thoroughly assessed by a qualified physiotherapist will help identify the specific issues contributing to your shoulder pain, which means that treatment will be adjusted specifically to your needs.
What about a corticosteroid (cortisone) injection?
Some patients may have been recommended a cortisone injection by their GP to help reduce the amount of inflammation. Whilst research suggests that cortisone injections can provide better short-term relief compared to exercise, exercise is far superior in the long-term. Many patients that had injections initially had lost all the pain relief by six months, and some had even worse pain and function than before (Pieters et al., 2020). Corticosteroid injections have also been shown to result in some negative side effects such as early degeneration of tendons.
As such, we don’t recommend cortisone injections as first line treatment for this type of shoulder pain given the available research and guidelines.
When will my shoulder get better?
It takes time before you start to see the benefits from starting exercise, whether it’s for weight loss, getting stronger or reducing pain. Thus, we recommend sticking with the process for at least four to six weeks. This time frame will allow the muscles and other structures of the shoulder to adapt and become stronger.
Many patients actually notice improvements much earlier than four weeks, which tells us that even starting exercise or making small changes can be effective for managing pain! But to ensure that the improvements withstand the test of time, it’s a good idea to continue with the exercise program for the duration recommended by your physiotherapist. Recent research has also shown that ongoing exercise helps to promote the overall shoulder health, which means that you can effectively prevent shoulder pain in the future! (Schmidt et al., 2021).
This sounds a lot like my shoulder problem!
If you think you have shoulder bursitis or a different shoulder problem, call us now on 1300 738 609 or book online to make an appointment with one of our physiotherapists! Let us help you find your Solution!