New York State Medical Treatment Guidelines for
Bursitis of the Shoulder in workers compensation patients

The New York State workers compensation board has developed these guidelines to help physicians, podiatrists, and other healthcare professionals provide appropriate treatment for Bursitis of the Shoulder.

These Workers Compensation Board guidelines are intended to assist healthcare professionals in making decisions regarding the appropriate level of care for their patients with ankle and foot disorders. The guidelines are not a substitute for clinical judgement or professional experience. The ultimate decision regarding care must be made by the patient in consultation with his or her healthcare provider.

Bursitis of the Shoulder for Shoulder Injury

Acute or chronic shoulder bursitis typically manifests as localised pain and discomfort in the shoulder and may be brought on by trauma, long-term usage, inflammatory arthritis, or acute or chronic infection.

History and Mechanism of Injury

• Mechanism of Injury: The degree, kind, length, and frequency of any accompanying pain and discomfort should be correlated with the onset of symptoms, date, mechanism of onset, occupational history, and current requirements.
• Nighttime pain, pain during over-the-shoulder activities, a sense of shoulder weakness, prior therapy for the presenting complaint(s), specific movement restrictions, and related familial history are all possible parts of the history.

Physical Findings of Bursitis of the Shoulder

Physical Findings may include:

• Localised soreness over the specific bursa or inflamed tendon is felt upon palpation, along with loss of mobility when moving;
• Between 40 and 120 degrees, there could be a painful arc; and/or
• Bursitis may be linked to other shoulder injury diagnoses like impingement, rotator cuff instability, tendinitis, etc. For more information, see the relevant diagnosis subsections.

Laboratory Tests of Bursitis of the Shoulder

Laboratory Tests of Bursitis of the Shoulder are recommended clinically appropriate in a subset of patients.

Indications: When an appropriate clinical presentation suggests that testing is required due to a systemic illness or disease, laboratory tests may be done to rule out the condition.

Sedimentation rate, rheumatoid profile, complete blood count (CBC) with differential, and serum uric acid level testing may be performed on rare instances, where warranted. Bursal aspiration with fluid analysis may also be required, as well as routine screening for other medical conditions.

Testing Procedures of Bursitis of the Shoulder X-Ray

Testing Procedures of Bursitis of the Shoulder X-Ray are recommended clinically appropriate in a subset of patients.

Indications: Simple x-rays can be taken to rule out any additional shoulder pathology.

Non-Operative Treatment Procedures

• Non-operative treatment techniques include immobilisation, therapeutic exercise, changing one’s occupation or workstation, thermal therapy, and ultrasound may provide benefits.
• When shoulder pain is acute, the use of passive modalities alone should be restricted to the first two to three weeks. Active therapies should then be used as soon as they are appropriate.
• Returning to work without engaging in overhead tasks and heavy lifting until a doctor has given the all-clear for those and heavier activities.
• Physical medicine and rehabilitation, including education in therapeutic exercise, good work technique, and manual therapy, as well as vocational rehabilitation, vocational evaluation, and interdisciplinary team approach, may be used as additional modalities or treatment processes.

Biofeedback of Bursitis of the Shoulder

Biofeedback of Bursitis of the Shoulder is not recommended. You might think about using drugs like nonsteroidal anti-inflammatories, oral steroids, and analgesics.

Intrabursal Injection with Steroids of Bursitis of the Shoulder

Intrabursal Injection with Steroids of Bursitis of the Shoulder is recommended

Frequency:

Not more often than twice or three times per year. One or two injections are typically sufficient. It is advised to wait at least three weeks between injections.

Maximum duration: Three injections to the same place each year are permitted.

Operative Procedures of Bursitis of the Shoulder

Operative Procedures of Bursitis of the Shoulder is not recommended – for pure bursitis.

What our office can do if you have Bursitis of the Shoulder

We have the experience to help you with their workers compensation injuries. We understand what you are going through and will meet your medical needs and follow the guidelines set by the New York State Workers Compensation Board.

We understand the importance of your workers compensation cases. Let us help you navigate through the maze of dealing with the workers compensation insurance company and your employer.

We understand that this is a stressful time for you and your family. If you would like to schedule an appointment, please contact us so we will do everything we can to make it as easy on you as possible.