Quick Summary
Shoulder bursitis (subacromial bursitis) is inflammation of the fluid-filled sac that cushions the tendons at the top of your shoulder, causing pain when you lift your arm or lie on it at night.
Our HCPC-registered physiotherapists use exercise therapy and manual therapy — the approaches with the strongest research support — to reduce your pain and restore movement. Most people improve with a structured programme, and we will guide you at every stage.
What Is Shoulder Bursitis?
The subacromial bursa is a thin, fluid-filled sac that sits between the acromion (the bony roof of your shoulder) and the rotator cuff tendons beneath it. Its job is to reduce friction so the tendons glide smoothly as you raise your arm. When this bursa becomes irritated or inflamed, the space becomes painful and swollen, and lifting your arm overhead can feel sharp or catching.
The bursa rarely becomes inflamed in isolation. Clinicians increasingly use the umbrella term subacromial pain syndrome — historically called shoulder impingement — to describe pain from this region, because bursitis and rotator cuff tendinopathy frequently coexist and are managed along the same evidence-based pathway (Pieters et al., Journal of Orthopaedic & Sports Physical Therapy, 2020).
This is why our physiotherapists assess your whole shoulder rather than treating the bursa as a separate problem. The bursa itself is highly sensitive, which explains why it can be so painful even when the underlying structures are relatively intact (Faruqi & Rizvi, StatPearls, 2023).
Do You Experience These Symptoms?
✓ Pain and tenderness at the top and outer part of your shoulder
✓ A painful arc — pain that is worst when raising your arm between waist and shoulder height
✓ Pain reaching overhead — into cupboards, washing your hair, or putting on a coat
✓ Night pain, especially when lying on the affected side, disturbing your sleep
✓ Swelling or a feeling of fullness at the top of the shoulder
✓ Weakness that is usually caused by pain rather than true loss of strength
✓ Difficulty with everyday tasks such as fastening a seatbelt or reaching behind your back
These symptoms can be treated.
The sooner you begin, the better your chances of a smoother recovery.
What Causes Shoulder Bursitis?
• Repetitive overhead activity
The most common cause is repeated overhead use, from work such as painting or plumbing, or sports such as swimming and tennis.
Repeated compression of the bursa under the acromion irritates it and triggers inflammation.
• Sudden increases in load
A rapid spike in activity — a burst of DIY, a new gym routine, or an unaccustomed heavy task — can overwhelm a shoulder that was previously coping.
This training-error pattern is one of the most common triggers we see in clinic.
• Direct trauma or a fall
A blow to the shoulder or a fall onto an outstretched arm can inflame the bursa directly.
Repeatedly leaning on your elbow, which drives the arm bone upward into the bursa, can also aggravate it.
• Age-related and structural changes
From around the age of 40, tendons become less elastic and the subacromial space can narrow, sometimes due to bone spurs or the shape of the acromion.
Research suggests age over 50 substantially increases the risk of subacromial problems (Sayampanathan & Andrew, Journal of Rehabilitation Medicine, 2019).
• Underlying health conditions
Inflammatory and metabolic conditions such as rheumatoid arthritis, gout and diabetes increase the risk of bursitis.
Evidence shows diabetes roughly doubles the risk of rotator cuff-related shoulder problems.
How We Treat Shoulder Bursitis at J&J Therapy
Hands-On Manual Therapy
Our physiotherapists use hands-on manual therapy — including joint mobilisation of the shoulder and thoracic spine and soft-tissue techniques — to help reduce your pain and improve movement. UK guidance supports including manual therapy in the early phase of care, and evidence shows its benefits are greatest when combined with active exercise rather than used alone.
Shockwave Therapy*
Swiss Storz Medical MASTERPULS may complement your manual therapy and exercise programme when your physiotherapist identifies specific indications during assessment. Non-invasive, evidence-based.
Targeted Exercise Programme
Exercise therapy is the cornerstone of evidence-based care for subacromial pain. We design a progressive, individually tailored programme focusing on strengthening your rotator cuff and shoulder blade muscles, restoring range of movement, and gradually reloading your shoulder — combined with education and load-management advice so you can return to the activities that matter to you.
When to Seek Urgent Medical Help
While most symptoms are not serious, urgent medical attention is required if you experience any of the following:
Signs of infection — a hot, intensely red, very swollen shoulder, particularly with fever, chills or feeling generally unwell (seek same-day medical care)
Shoulder pain after a fall or injury, inability to lift your arm, or an obviously deformed shoulder
Unexplained weight loss, night sweats, a lump or swelling, or numbness and significant weakness in your arm
Pain that fails to improve after two weeks of self-care or is progressively worsening
FAQs About Shoulder Bursitis
How long does shoulder bursitis take to recover?
Recovery varies from person to person. Many people improve over several weeks to a few months with a structured exercise programme, and UK guidance suggests giving rehabilitation a minimum of 6–12 weeks. We set realistic milestones with you and adjust your programme as you progress.
Do I need a scan or an X-ray?
Usually not. Subacromial pain is a clinical diagnosis, and imaging is reserved for cases that do not respond as expected, significant trauma, or red-flag symptoms. Our physiotherapists will advise you if a referral for imaging is appropriate.
Should I rest my shoulder completely?
No. While it helps to temporarily reduce activities that flare your pain, complete rest can allow the shoulder to stiffen. The evidence supports keeping your shoulder moving within a comfortable range and gradually reloading it.
Can shockwave therapy help my bursitis?
Shockwave is not a first-line treatment for shoulder bursitis, and current UK guidance found limited evidence of benefit for subacromial pain. We would only consider it when your assessment indicates it may help — for example, if we identify confirmed calcific tendinopathy, where the evidence is stronger. We will always be honest with you about what the research does and does not show.
Will I need an injection or surgery?
Most people do not. Exercise and manual therapy are first-line, and a corticosteroid injection may give short-term relief if pain is limiting your rehabilitation. Surgery is considered only when a thorough course of conservative care has not helped.
This page is for general information only and does not replace professional medical advice.
Reviewed by Lavya Arigalayan, MSc, HCPC Registered Physiotherapist.
Last reviewed:
2026년 8월 17일