Shoulder pain that just won’t budge can be exhausting. When it stops you reaching up, sleeping comfortably or simply going about your day, it’s easy to feel stuck. One of the most common queries is how to treat bursitis in the shoulder.
It’s a condition that often comes on slowly but can leave you with sharp pain or an aching discomfort that just doesn’t settle. The good news? You don’t have to put up with it. With the right approach, you can get back to doing the things you enjoy, without the pain.
A bursa is a small, fluid-filled sac found near your joints. It acts as a cushion between bones, muscles, and tendons – reducing friction and helping everything move smoothly.
In the shoulder, the subacromial bursa is the one that usually causes problems. When it becomes irritated or inflamed, it swells up, causing pain and restricting movement. That inflammation is what we call bursitis.
Bursitis often builds up over time, particularly if you regularly do activities that involve lifting your arm or reaching overhead. It can also be triggered by poor posture, a knock to the shoulder, or other shoulder conditions like impingement or rotator cuff problems.
Common causes include:
- Repeated overhead movement (like painting, swimming, or lifting at the gym)
- Long periods of poor posture
- Shoulder weakness or instability
- A direct fall or impact to the shoulder
- Conditions like rheumatoid arthritis or gout
Typical Symptoms
Bursitis doesn’t always shout at you straight away. In many cases, it starts off with a dull ache that gradually worsens. But if left untreated, it can become more painful and limiting over time.
Common symptoms include:
- Pain on the outside or top of the shoulder
- Discomfort when lifting your arm, especially overhead
- Difficulty sleeping on the affected side
- Reduced range of motion
- Swelling or warmth (in some cases)
These symptoms can be like other shoulder conditions, which is why getting a proper assessment can be helpful.
The most effective way to treat this condition is by reducing irritation, improving movement, and gradually restoring strength and stability. Most people can fully recover without the need for surgery, especially if they act early. Recovery is often centred around physiotherapy, but treatment plans can vary. Recovery could include:
1. Reduce Aggravating Movements
One of the first things to do is identify what’s making the bursitis worse. Repeated overhead movements, heavy lifting or long periods of poor posture can all put pressure on the shoulder.
The aim isn’t to stop moving completely. That can lead to stiffness and weakness, but to adjust how you move so the bursa has a chance to settle. This might mean lowering the weights in the gym, taking more breaks at work, or avoiding certain sleeping positions for a while.
2. Recovery Through Movement and Strength
One of the most effective ways to treat bursitis in the shoulder is by gently restoring movement and building strength. This usually starts with easing stiffness and pain using light stretches and controlled movement, followed by exercises that focus on the small muscles that help stabilise the joint.
Just like with shoulder tendonitis (tendinopathy), it’s important to reduce irritation first, then gradually strengthen the area to prevent the problem from coming back. A structured exercise plan can help improve posture, shoulder control, and confidence in movement over time.
Working with a specialist who understands shoulder mechanics can make a big difference, especially if your pain has been going on for a while or keeps returning.
3. Supportive Therapy for Active Recovery
If you’re someone who enjoys sport, exercise, or a physically demanding job, your rehab may need to go a bit further. Sports therapy looks at getting the shoulder pain-free again and at making sure you don’t end up back in the same situation.
This kind of treatment often includes:
- Stability drills for the rotator cuff and shoulder blade
- Postural retraining for better control and positioning
- Activity-specific strengthening to match your sport or job
- Guidance on training loads and technique
4. Hands-On Treatment for Pain Relief
Massage therapy and hands-on techniques can be a helpful addition to your recovery, especially when there’s a lot of tightness or tension around the shoulder. Releasing the surrounding muscles can reduce the strain on the bursa and make movement easier.
You might benefit from:
- Soft tissue massage
- Trigger point release
- Manual mobilisation of the shoulder joint
This kind of therapy can also help if you’ve been subconsciously guarding or protecting the shoulder, which often leads to stiffness or overuse in other areas like the neck or upper back.
5. Ice and Anti-Inflammatories
In the early stages, using ice can help to calm things down. Applying an ice pack to the shoulder for 15 to 20 minutes, a few times a day, may reduce swelling and numb some of the pain.
Over-the-counter anti-inflammatory medication can also help, especially when symptoms first appear. These should only be used short-term and in line with medical advice, particularly if you have any underlying conditions.
6. Posture and Ergonomics
Posture isn’t always the root cause of bursitis, but it can make things worse. Rounded shoulders or a slouched upper back can change the mechanics of the shoulder joint, putting more pressure on the bursa.
Making a few simple changes can ease that load:
- Adjusting your desk set-up
- Taking more regular breaks from sitting
- Strengthening your upper back and postural muscles
- Sleeping in a more shoulder-friendly position
A specialist can help you spot small tweaks that make a big difference to how your shoulder feels day to day.
7. Gradual Return to Your Normal Routine
Once pain has settled, it’s tempting to get straight back to all the things you were doing before, but jumping in too quickly can lead to flare-ups!
Instead, aim for a gradual build-up:
- Start with low-load, high-rep movements
- Avoid high-impact or overhead actions at first
- Monitor how your shoulder feels during and after activity
- Keep doing your rehab alongside your return to sport or work
Taking this step-by-step approach can help you avoid setbacks and build confidence in your shoulder again.
8. When Other Treatments May Be Needed
In most cases, bursitis settles with rest, movement, and strengthening. But if your pain is stubborn or returns frequently, you might be advised to try other options.
One of these is steroid injection therapy. This involves injecting a small amount of corticosteroid into the bursa to quickly reduce inflammation. It’s often used alongside rehabilitation to help you regain movement and begin strengthening again without pain holding you back.
Injections aren’t a long-term fix, but they can be helpful when used at the right time.
Physiotherapy and Shoulder Bursitis
Many of the techniques mentioned above fall under the wider umbrella of physiotherapy and can be recommended by your therapist. Physiotherapy as a discipline offers a structured and clinically guided approach. Patients should expect to begin with a full assessment to gain a diagnosis, tailored exercise plan, and hands-on support. All the direction needed to give you a clear route back to full shoulder function.
An accredited therapist will look at the root cause, posture, muscle imbalances, work demands, or sporting impacts to your shoulder. They’ll also consider your lifestyle, medical history and build a plan that supports your long-term recovery.
Everyone’s recovery journey is slightly different. Some people notice an improvement within a couple of weeks, while others may need a longer course of rehab if the bursitis has been there for a while.
Timelines can vary and be anywhere from 2 weeks to 6 months.
The most important thing is to stay consistent. With rest, rehab, and the right support, even long-standing bursitis can be managed successfully.
Do you need help with shoulder pain?
Living with shoulder bursitis can affect your work, sleep, sport and daily routine. But it’s also a condition that responds really well to the right combination of movement, strength, and lifestyle changes.
If you’ve been wondering how to treat bursitis in the shoulder, the answer starts with understanding the cause, then working through a plan that eases irritation and rebuilds strength and control.
At True Physio, our team understands just how much shoulder pain can impact your life. With expert-led rehab, hands-on bursitis treatment, and tailored support, we’re here to help you recover fully and safely.
If you’d like to take your first step to recovery, book an appointment with us today at your local clinic, we’d love to help you get back to what you love, pain-free and confident.