• 22 Sep, 2026
• UnityPain
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Subacromial Bursitis: Causes & Treatment | UnityPain

When Shoulder Pain Won’t Let You Rest

If you’ve been waking up at night because your shoulder aches, or you can’t reach up to a shelf without wincing, you are not alone. Shoulder pain is one of the most common reasons people visit a doctor. And one of the most frequent causes is something called subacromial bursitis. It can make simple, everyday tasks feel impossible. Getting dressed, lifting a bag, or even sleeping on your side can become a real struggle.

Living with that kind of pain is exhausting — not just in your body, but in your mind too. The good news is that subacromial bursitis is well understood, and there are real treatment options that can help. This article will walk you through what it is, what causes it, and what kinds of care are available so you can start feeling better.

What Is Subacromial Bursitis?

Your shoulder is a complex joint made up of bones, tendons, and muscles that all work together. Between the top of your upper arm bone and the bony tip of your shoulder (called the acromion) there is a small, fluid-filled sac called the bursa. This sac acts like a cushion. It helps your tendons glide smoothly without rubbing against bone.

When that bursa becomes inflamed and swollen, it is called bursitis. In the subacromial space — the area just under the acromion — this swelling can press on the surrounding tendons and cause significant pain. Even small shoulder movements can feel sharp and uncomfortable. Over time, if it is not treated, the inflammation can worsen and limit how much you can move your arm.

What Causes Subacromial Bursitis?

There is no single cause of subacromial bursitis. For many people, it develops from repetitive overhead movements. Jobs or hobbies that involve reaching, throwing, or lifting above shoulder height — like painting, swimming, playing tennis, or working in construction — can gradually irritate the bursa over time. This is sometimes called an overuse injury.

Other times, bursitis can start after a fall or a direct blow to the shoulder. Age also plays a role. As we get older, the tendons and soft tissues in the shoulder naturally become less flexible and more prone to irritation. Conditions like rotator cuff tears, bone spurs, or poor posture can also narrow the subacromial space, which makes the bursa more likely to get squeezed and inflamed. Sometimes, bursitis appears without any clear reason at all — and that can be especially frustrating when you’re trying to find answers.

What Are the Symptoms?

The most common symptom is a dull, aching pain in the outer part of the shoulder or upper arm. This pain often gets worse when you lift your arm out to the side or reach overhead. Many people notice the pain is worse at night, especially when lying on the affected shoulder. This kind of nighttime pain can seriously disrupt sleep, which makes everything harder to manage.

You may also notice:

• Stiffness or limited range of motion in the shoulder
• Tenderness when pressing on the top or outer side of the shoulder
• Pain that radiates down the upper arm toward the elbow
• A feeling of weakness when lifting or rotating the arm

These symptoms can look similar to other shoulder conditions, like rotator cuff injuries or shoulder impingement syndrome. That is why getting a proper evaluation from a healthcare provider is so important. Treating the wrong problem will not help — and can sometimes delay real relief.

How Is Subacromial Bursitis Diagnosed?

A doctor will usually start by asking about your symptoms, your daily activities, and how long the pain has been going on. Then they will do a physical exam, moving your arm in different directions to see which movements cause pain. There are specific tests — like the Neer test and the Hawkins-Kennedy test — that help identify impingement and bursitis in the subacromial space.

Imaging can also be helpful. An X-ray can show bone spurs or changes in the joint. An ultrasound can identify fluid in the bursa and is often done right in the office. In some cases, an MRI may be ordered to get a more detailed look at the tendons and soft tissues. Having a clear picture of what is going on inside your shoulder helps your care team recommend the right treatment for you.

Treatment Options for Subacromial Bursitis

The goal of treatment is to reduce inflammation, relieve pain, and help you get back to moving your arm without discomfort. For mild to moderate bursitis, rest and activity modification are often the first steps. Avoiding the movements that trigger your pain gives the bursa a chance to calm down. Applying ice to the area for 15 to 20 minutes several times a day can also help reduce swelling.

Physical therapy is one of the most effective long-term treatments. A therapist can teach you exercises that strengthen the muscles around your shoulder, improve posture, and restore range of motion. This helps take pressure off the bursa and prevents the problem from coming back. Anti-inflammatory medications, either over-the-counter or prescribed, may also be used to help manage pain and swelling during recovery.

When conservative treatments are not providing enough relief, a corticosteroid injection into the subacromial space can be very effective. This type of injection delivers anti-inflammatory medication directly to the inflamed bursa, often bringing significant relief within days. At Unity Pain Management in Modesto, CA, joint injections are one of the services offered to help patients find meaningful relief from shoulder pain. The team takes time to evaluate each patient individually and works to find the right approach for your specific situation.

A Hopeful Path Forward

Subacromial bursitis is painful, but it is also treatable. Many people see real improvement with the right combination of rest, physical therapy, and medical care. You do not have to keep pushing through the pain alone, and you do not have to assume this is just something you have to live with forever.

If shoulder pain has been slowing you down, reaching out for help is a strong and important first step. Whether you need a thorough evaluation, a referral to physical therapy, or a targeted injection, Unity Pain Management accepts most insurance plans and offers telehealth visits for added convenience. There are people who understand what you are going through — and real options that may help you get your life back.

References

• Childress, Mark A. and Brou Bhatt. “Subacromial Corticosteroid Injections for Shoulder Pain: A Systematic Review.” American Family Physician. 2020.
• Trojian, Thomas, et al. “Shoulder Pain Diagnosis and Management in Primary Care.” StatPearls, National Library of Medicine (NIH). 2023.
• Mayo Clinic Staff. “Bursitis.” Mayo Clinic. 2023.
• Navarro-Ledesma, Santiago, et al. “Effectiveness of Physical Therapy in the Treatment of Subacromial Impingement Syndrome.” Journal of Clinical Medicine. 2021.
• Diercks, Ron, et al. “Guideline for Diagnosis and Treatment of Subacromial Pain Syndrome.” Acta Orthopaedica. 2014.