What is shoulder bursitis?
A bursa is a small, fluid-filled sac that reduces friction between tendons and bone. In the shoulder, the largest is the subacromial bursa, which sits between the rotator cuff tendons and the bony roof of the shoulder (the acromion). Subacromial bursitis means this bursa has become inflamed and thickened.
Shoulder bursitis is often part of a wider problem called subacromial pain or shoulder impingement, alongside rotator cuff tendinopathy. Symptoms include:
- Pain on the outer side of the upper arm or shoulder
- Pain when lifting the arm out to the side or overhead (a “painful arc”)
- Pain lying on the affected side at night
- Tenderness, but usually a near-normal range of movement when helped
The NHS bursitis guide explains the condition in plain language. Shoulder bursitis treatment depends on the cause and on what else is happening in the shoulder.
What causes subacromial bursitis?
- Repetitive overhead activity: painting, swimming, racquet sports, lifting at work
- Rotator cuff problems: tendinopathy or a rotator cuff tear changes how the shoulder moves and irritates the bursa
- Injury: a fall or direct blow
- Inflammatory conditions: such as rheumatoid arthritis or gout
- Infection: rare in the shoulder, but needs urgent treatment if there is fever or a hot, red joint
How it is diagnosed
A doctor examines your shoulder movement, strength and specific tests for impingement and rotator cuff function. Imaging helps separate bursitis from other problems:
| Test | What it shows |
|---|---|
| Ultrasound | Bursa thickening and fluid, rotator cuff tendons, guidance for injections |
| MRI | Bursitis, tendon tears, cartilage and bone in detail |
| X-ray | Calcium deposits, arthritis, bone spurs |
Shoulder bursitis vs other shoulder conditions
| Condition | Key feature |
|---|---|
| Subacromial bursitis | Painful arc, movement mostly preserved |
| Rotator cuff tear | Weakness lifting or rotating the arm |
| Frozen shoulder | Marked stiffness; arm will not move even when helped |
| Calcific tendinitis | Sudden severe pain; calcium seen on X-ray |
| Shoulder arthritis | Grinding, stiffness, usually older adults |
| Neck problems | Pain spreading down the arm with tingling |
The NHS shoulder pain page describes these common causes.
Conventional treatment for bursitis in the shoulder
Most people improve with simple care:
- Activity modification: reduce repeated overhead work and heavy lifting for a period, while keeping the shoulder moving.
- Pain relief: paracetamol or short courses of anti-inflammatories where suitable; ice can ease flares.
- Physiotherapy: a progressive exercise programme strengthening the rotator cuff and shoulder blade muscles is the main long-term treatment.
- Corticosteroid injection: an injection into the subacromial space can reduce pain for weeks, helping you do your exercises. Effects are often short term and repeated injections are limited. See PubMed research on steroid injection for subacromial bursitis.
- Surgery: arthroscopic subacromial decompression was once common. A large UK randomised trial (CSAW) found it offered no meaningful benefit over a placebo-type arthroscopy for subacromial pain, so it is now used far more selectively.
The MedlinePlus bursitis page is a further reliable source.
Self-help for shoulder bursitis
Everyday changes support recovery and reduce flare-ups:
- Keep the arm moving within comfort to prevent stiffness; avoid a sling unless advised.
- Limit overhead work for a period, and keep frequently used items at shoulder height or below.
- Sleep on the other side or with a pillow supporting the painful arm.
- Take breaks during repetitive tasks such as painting, gardening or computer work.
- Do your exercises consistently. Strengthening the rotator cuff and shoulder blade muscles is what changes the long-term picture.
- Seek prompt care for fever, a hot red shoulder or sudden loss of strength.
Regenerative options: what the evidence says
Regenerative treatments for shoulder bursitis are not approved standard care in the US, UK or Australia.
- PRP therapy: platelet-rich plasma injected into the subacromial space has been compared with steroid injection in small randomised trials. Some found similar or longer-lasting pain relief; others found little difference. Studies are small and use different methods. See PubMed research on PRP for subacromial bursitis.
- Stem cell therapy: studied mainly for rotator cuff tendon repair, not bursitis on its own; human evidence is early.
- Exosome therapy: laboratory and early research only.
The FDA warns about unapproved stem cell and exosome products.
Who may be a candidate for regenerative care?
- Shoulder pain lasting more than three months despite physiotherapy
- Pain that returned after one or more steroid injections, or a wish to avoid further steroid
- Ultrasound or MRI confirming bursitis or rotator cuff tendinopathy as the cause
- Realistic expectations about early, mixed evidence
Who should not have regenerative treatment
- Suspected infected bursitis (fever, hot red shoulder): urgent medical care is needed
- Large, full-thickness rotator cuff tears needing a surgical opinion
- Frozen shoulder, advanced arthritis or pain coming from the neck
- Active infection, cancer, blood or platelet disorders, or pregnancy
Risks and side effects
Shoulder injections commonly cause soreness for a few days, and PRP can cause a short pain flare. Uncommon risks include infection, bleeding and allergic reaction. Repeated steroid injections may weaken tendons. Ultrasound guidance improves accuracy. Cells used in our programmes are prepared in ISO 9001:2015-certified partner laboratories.
Treatment in Bangkok: how it works
- Before travel: send your ultrasound or MRI and reports on WhatsApp. A doctor reviews whether a regenerative program is reasonable or whether more physiotherapy or a surgical opinion is the better next step.
- In Bangkok: consultation, examination, ultrasound review and any agreed image-guided procedure.
- Back home: a shoulder exercise plan and follow-up on WhatsApp.
Patients come from Australia, the UK, the US and Canada. You can send your MRI for a free review, and see how it works for the full process. No outcome can be guaranteed.
Frequently asked questions
How long does shoulder bursitis last?
Many people improve within a few weeks to a few months with activity changes and exercise. It can last longer if the underlying cause, such as rotator cuff tendon problems or overuse, is not addressed.
What is the fastest way to treat shoulder bursitis?
There is no instant fix. Avoiding aggravating overhead activities, pain relief and a physiotherapy programme work for most people. A steroid injection can reduce pain quickly for some, which can make exercise easier, but the effect is often temporary.
Is shoulder bursitis the same as a rotator cuff tear?
No. Bursitis is inflammation of the fluid-filled sac above the rotator cuff. A rotator cuff tear is damage to the tendons themselves. The two often occur together, and an ultrasound or MRI can tell them apart.
Should I keep using my arm with shoulder bursitis?
Yes, within comfort. Complete rest can lead to stiffness. Avoid repeated overhead movements and heavy lifting that provoke pain, and follow a graded exercise programme.
Can PRP help shoulder bursitis?
Small trials have compared PRP with steroid injections for subacromial pain, with mixed results. It is not a standard first-line treatment, but a doctor may discuss it if symptoms persist despite good conventional care.
How much does shoulder bursitis treatment in Bangkok cost?
It depends on your diagnosis, imaging and the plan a doctor recommends. Send your MRI or ultrasound report on WhatsApp for a free doctor review and a personalised program.
This page is general information, not medical advice, and does not replace a consultation with your own doctor. Results vary and no treatment outcome can be guaranteed. We are a patient coordination service and may receive a referral fee from partner medical providers. See our medical disclaimer and referral disclosure.