Shoulder bursitis (shoulder impingement) is caused by excessive rubbing of the rotator cuff and shoulder blade because of inflammation of the bursa, which is a fluid-filled sac that acts as a cushion between the bones and tendons in your shoulder. Shoulder bursitis is often caused by a sports, occupational or accident-related injury, but it also becomes more common with increasing age. While symptoms of shoulder bursitis usually begin as mild pain or loss of strength, the condition can become severe if temporary lifestyle modifications or other treatment is not undertaken.
Pain
Shoulder bursitis can cause pain that is present both at rest and when performing certain movements or activities. Pain can occur when the arm is lifted or lowered from an elevated position, and pain may come on suddenly when lifting or reaching for an object. Raising the arm over the head can cause pain, so athletes involved in sports such as tennis, basketball, or baseball might find it painful to throw, shoot or serve a tennis ball. Those involved in occupations such as painting or carpentry that involve a lot of overhead movement, reaching and lifting might also be susceptible to frequent pain. In some cases, the pain can radiate from the front of the shoulder down the side of the arm. When shoulder bursitis worsens, it is often accompanied by pain at rest or during the night while you sleep. Pain might become severe enough to waken you from sleep, particularly if you turn over onto the affected shoulder.
Inflammation
Shoulder bursitis is characterized by inflammation of the bursa and the tendons in the shoulder area. As these structures swell, they thicken and take up more space in the shoulder area, causing pinching or impingement of nerves. The pinching on the tendons and bursa inflames them even more, worsening inflammation and leading to even more impingement. You might experience localized swelling and tenderness in the front or outer side of the shoulder. It sometimes feels warm to the touch.
Loss of Strength and Motion
Shoulder bursitis can cause a loss of strength and motion, making it difficult to move your arm and shoulder as much as usual. You might also find that your upper arm and shoulder are weaker than normal, making it hard to lift, push or pull weight that previously was not too heavy for you. It might be especially difficult to perform activities that require placing your arm behind your back, like in zipping up a back zipper or even scratching your back. In acute bursitis, all forms of movement is limited and the shoulder will feel tender and painful. Advanced cases might cause "frozen shoulder," in which motion loss is progressive but then eventually "thaws" and shows signs of improvement.
According to the Hospital for Special Surgery, an inability to hold the arm in certain positions suggests that tendinitis (swelling of a tendon connecting muscle to bone) is present, and recurrent bouts with tendinitis might mean you have a rotator cuff tear.
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