Pain on the outer side of the shoulder is the most common symptom of shoulder bursitis.

Typically, people with shoulder bursitis have some combination of the 8 symptoms listed below.

  1. Shoulder pain
    Early in the course of bursitis development, patients may feel mild shoulder pain when lifting the arms overhead. This pain may gradually increase over time and eventually pain may be felt even at rest.
  2. Pain that is worse after repetitive activity
    The pain may intensify after prolonged repetitive shoulder movements, such as painting, throwing a ball, or playing tennis.

    Pain that gets worse after inactivity may be a symptom of:

  3. Shoulder tenderness
    The outer shoulder may be tender and sensitive to pressure. Lying down or putting pressure on the affected side is often uncomfortable.
  4. Radiating pain
    Initially, the pain is located at the outside of the shoulder at the very top of the arm, but as symptoms progress, the pain may radiate down the outside of the arm (though rarely past the elbow).
  5. Muscle weakness
    As the condition gets worse, a person may avoid using the shoulder, causing the muscles to weaken.
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  1. Pain at extreme range of motion
    As symptoms progress it may become difficult to reach behind the back to put on a coat or zip a dress.
  2. No swelling
    Notable swelling, such as that seen in elbow or knee bursitis, is possible but often absent. Research suggests affected shoulder bursae thicken just 0.5 mm.1Tsai YH, Huang TJ, Hsu WH, Huang KC, Li YY, Peng KT, Hsu RW. Detection of subacromial bursa thickening by sonography in shoulder impingement syndrome . Chang Gung Med J. 2007 Mar-Apr;30(2):135-41. PubMed PMID: 17596002.
  3. Fever, tiredness, and skin redness and warmth
    People with septic shoulder bursitis, in which the bursa is infected, will experience the symptoms listed above and may also feel feverish, tired, and sick. They may also notice warmth and redness at the shoulder. Septic shoulder bursitis is serious and requires treatment with antibiotics to prevent the spread of infection into the bloodstream.

    See Septic Bursitis

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In the absence of a trauma to the shoulder, bursitis symptoms typically have a gradual onset. If symptoms appear suddenly and without a clear cause (such as a fall or overuse) a call to a health care provider is advisable.

Dr. C. Benjamin Ma is an orthopedic surgeon and the Vice Chairman for Adult Clinical Operations in the Department of Orthopaedic Surgery at the University of California, San Francisco Medical Center. Dr. Ma has been practicing medicine for more than 15 years, specializing in sports medicine and knee and shoulder surgery.

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