fbpx

Is My Shoulder Pain from Arthritis or Bursitis?

Your shoulders are packed with bones, muscles, tendons, and ligaments. Shoulder pain can develop from a variety of conditions that affect one—if not many—of these structures. While this can make it difficult to pinpoint the exact source of your shoulder pain, an accurate diagnosis and proper treatment are the key to recovery.

Arthritis and bursitis are two of the most common causes of shoulder pain; however, they can be difficult to differentiate. The following article will help you determine if your shoulder pain is caused by arthritis or bursitis.

What is Shoulder Arthritis?

Arthritis is derived from the Greek word, “arthron”, which means joint and the Latin suffix “itis”, meaning inflammation. In the past, arthritis was defined by inflammation in one or more of the body’s joints. Today, arthritis has come to describe any disease that wears away cartilage, which is the smooth tissue that covers the ends of bones where they meet and reduces friction. Arthritis affects not only joints, but also muscles, tendons, and ligaments.

The three most common forms of shoulder arthritis are: osteoarthritis, which is a degenerative joint disease; post-traumatic arthritis, which is a disease that results from an injury; and rheumatoid arthritis, which is an autoimmune disease. Joint pain and limited range of motion are characteristic of every form of the disease. Additional symptoms will depend on the exact type of arthritis affecting your shoulder.

Symptoms of Shoulder Arthritis

Shoulder arthritis may cause any of the following symptoms:

  • Shoulder pain that gradually becomes worse with time
  • Shoulder pain that becomes worse after a period of inactivity (e.g. sleep)
  • Shoulder pain with certain motions (e.g. reaching overhead)
  • Shoulder tenderness and sensitivity to pressure
  • Shoulder stiffness or loss of motion
  • Swelling in the shoulder joint
  • Muscle weakness in the shoulder
  • Popping, crunching, or catching sensation in the shoulder

Osteoarthritis

Osteoarthritis—sometimes called “wear and tear arthritis” or degenerative joint disease—is the form of arthritis that is most likely to affect the shoulder, in addition to being the most common chronic joint condition overall. It is a degenerative condition that destroys the smooth articular cartilage of the shoulder, leading to pain, swelling, and immobility. In the final stages of osteoarthritis, cartilage is fully worn away and bone rubs against bone.

The risk for osteoarthritis rises steeply after age 50 in men and age 40 in women. Repetitive, occupation-related injury and physical shoulder trauma can also contribute to the development of the disease. And, as with other forms of arthritis, genetics play an important role in the development of osteoarthritis.

Post-Traumatic Arthritis

Post-traumatic arthritis is a specific form of osteoarthritis that may occur if cartilage is damaged during an injury. Sports, military, or automobile accidents can all lead to the type of injuries that result in post-traumatic arthritis; however, so can a fall or a traumatic blow to the shoulder. Chronic overuse of the shoulder as well as excess body weight can also accelerate the progression of the disease.

Rheumatoid Arthritis

Rheumatoid arthritis is an autoimmune disease that occurs when the body’s immune system mistakenly attacks the synovium membrane, which lines the cavities of joints and other structures. If left untreated, rheumatoid arthritis will eventually damage adjacent cartilage and bone, resulting in pain, swelling, inflammation, and loss of function. It is also symmetrical, meaning that it usually affects both shoulders.

It is important to note that rheumatoid arthritis can develop, progress, and worsen with minimal or no apparent symptoms. Moreover, because characteristics of the rheumatoid arthritis overlap with other conditions, it is possible for it to be misdiagnosed, allowing the disease to progress further and delaying the appropriate treatment.

What is Shoulder Bursitis?

Bursitis occurs when the bursa, a fluid-filled sac that protects the outside of a joint, becomes inflamed. While it can be caused by acute trauma to the shoulder, it is more likely to result from chronic overuse of the joint. Moreover, because the structures of the shoulder are closely packed together, inflammation that begins in one of the five bursae in joint will eventually impact the others. Therefore, shoulder bursitis is often not only the result of an injury but also likely to create additional complications.

Symptoms of Shoulder Bursitis

Shoulder bursitis may cause any of the following symptoms:

  • Shoulder pain located at the top and outside of the joint
  • Shoulder pain that is triggered by movement or repetitive motion
  • Shoulder pain that gradually becomes worse
  • Shoulder tenderness and sensitivity to pressure
  • Shoulder redness and warmth
  • Muscle weakness in the shoulder
  • Fever (if caused by an infection)

The subacromial bursa is the largest bursa in the body and is highly susceptible to bursitis. It is located below the acromion, the large bony projection on the scapula (shoulder blade). This is why the majority of pain associated with shoulder bursitis occurs at the top and outside of the joint and radiates down the arm. It should also be noted that, although bursitis is the result of inflamed soft tissue, visible swelling is rare. Shoulder bursae do not have to be much thicker than normal to cause pain and so it is unlikely that you will have any visible signs aside from some minor redness.

Athletes, first and foremost, face the greatest risk of developing bursitis. This is particularly true of baseball pitchers, tennis players, and swimmers. Their greater than average risk is the result of not only their activities on the field but also from hours of repetitive, physically demanding training all year round. Moreover, the risk of bursitis is not limited to collegiate and professional athletes. Rapid growth, decreased flexibility, training errors, and overspecialization in one sport or activity can also contribute to a young athlete’s risk of developing bursitis.

Manual laborers, especially those who use their shoulder to perform overhead motions, are also prone to develop bursitis. This includes, but is not limited to, construction workers, factory workers, and painters.

Even hobbies and household chores can lead to bursitis if the shoulder is not given adequate rest. Examples include cleaning, gardening, and hanging clothes to dry. It is important to take note of what activities at home involve your shoulder and make an effort to space them apart.

Is it Arthritis or Bursitis?

In the most general sense, arthritis is a long-lasting condition that affects bones and cartilage while bursitis is a transient condition that affects bursae, tendons, ligaments, and muscles.

Arthritis

Bursitis

  • Characterized by a sharp, shooting, stabbing, throbbing, or stinging pain.
  • Characterized by pain, swelling, and one or more joints that feel warm to the touch.
  • Symptoms gradually worsen over months and years.
  • Symptoms only last for a few weeks if properly treated.
  • Results from wear and tear, trauma, and autoimmune responses.
  • Results from chronic overuse of the joint. It is less likely to result from a traumatic injury.
  • Pain and stiffness increases from inactivity.
  • Pain and stiffness increases with activity.
  • Joint damage is irreversible.
  • Bursae inflammation is transient.

Talk to a Shoulder Specialist

Dr. Robert Rolf is a board-certified shoulder specialist at Beacon Orthopaedics and Sports Medicine who can accurately diagnose your shoulder pain as arthritis or bursitis. He will talk to you about your symptoms, perform a comprehensive physical examination, and prescribe the appropriate treatment. You can schedule an appointment online to meet with Dr. Rolf.