Rotator Cuff Bursitis

Rotator cuff bursitis is inflammation of the bursa, a fluid-filled sac between the rotator cuff tendons and the acromion at the top of the shoulder, and it often occurs with rotator cuff tendonitis. When the swollen bursa and tendons get pinched between the acromion and the arm bone, it is called shoulder impingement. Pain relief after an injection of numbing medicine under the acromion helps confirm the diagnosis. Rest, ice, medication, therapy and steroid injections usually settle it within a few months, and arthroscopic removal of bone spurs and inflamed bursa is an option if they fail.

What is Rotator Cuff Bursitis?

The rotator cuff is a set of muscles and tendons which hold the various bones of the shoulder joint together, providing strength and support. Inflammation of the bursa, a fluid-filled sac between the rotator cuff tendons and a bony process at the top of the shoulder called the acromion, is known as shoulder bursitis or rotator cuff bursitis. It is often accompanied by inflammation of the tendons or rotator cuff tendonitis. The inflamed bursae and tendons can become compressed between the bones of the acromion and the upper arm, which is called shoulder impingement.

Causes of Rotator Cuff Bursitis

Rotator cuff bursitis and tendonitis are generally caused by repeated minor or unnoticed injuries to the shoulder joint, from overuse associated with certain professions or sports activities. They may also be caused by high-impact trauma during a fall or motor vehicle accident.

Other causes include:

• Bony growths of the acromion process
• The natural degeneration of tendons due to age, particularly in people over 40.

Symptoms of Rotator Cuff Bursitis

Signs and symptoms of rotator cuff bursitis include:

• Pain
• Tenderness
• Swelling
• Redness in the shoulder

Diagnosis of Rotator Cuff Bursitis

Your doctor will review your symptoms and medical history and perform a thorough physical examination to assess range of motion, blood flow, stability, and strength of the joint. Other diagnostic tests may include:

• X-ray
• MRI
• CT scan
• MRI scan
• Ultrasound

Your doctor may give an injection of an anesthetic drug in the space below the acromion to offer relief for the pain. If the pain is relieved, it indicates that the issue was tissue impingement due to bursitis or tendinitis.

Treatment for Rotator Cuff Bursitis

Rotator cuff bursitis can usually be treated with conservative measures such as rest, ice, over-the-counter pain medication, and lessening the pressure on the affected area by using a sling, walking cane, or other assistive devices. If these measures fail, you might require:

• Prescription pain medications including corticosteroid drugs to reduce inflammation and swelling, and antibiotics to treat infection
• Physical therapy to strengthen the muscles that surround the joint
• Injection of a steroid/anesthetic combination into the bursa
• Incision and drainage of the bursa to reduce swelling

Healing with conservative methods usually takes a few months. If these measures fail to produce a result, your doctor may recommend surgical treatment. The surgical procedure may be conducted either as an open surgery or arthroscopically. The procedure involves the removal of any bony overgrowths on the front end of the acromion bone or addresses any inflammation of the bursae in order to create more space for the rotator cuff and enable unrestricted movement of the joint.

This problem overlaps closely with broader shoulder bursitis and can produce similar aching and inflammation. Patients who describe lingering rotator cuff pain may actually have inflammation around the cuff rather than a tendon rupture. If symptoms do not improve, shoulder arthroscopy may be used to evaluate and treat the irritated tissue.