Bursitis of the shoulder (impingement syndrome) occurs when there is inflammation (swelling and redness) between the top of the arm bone (humerus) and the tip of the shoulder (acromion). Between these bones lie the tendons of the rotator cuff and a fluid-filled sac (the bursa) that protects the tendons. Normally, the tendons slide effortlessly within this space. In some people, this space becomes too narrow for normal motion. This causes irritation to the tendons and bursa, which become inflamed. Inflammation causes the tendons and bursa to swell, making the space for movement still smaller. Eventually, this space becomes too narrow for the tendons and the bursa. Every time they move, they are pinched between the bones. This is the impingement.
The key to preventing Shoulder Bursitis and rotator cuff problems is to address the problems of primary and secondary impingement. Where impingement is occurring, the space for the subacromial bursa is reduced. This space can be optimised by practicing shoulder stability exercises with a physiotherapist. These exercises concentrate on controlling the movement of the shoulder blade, by ensuring that muscle contract in the correct sequence during shoulder movements, to ensure that the ball of the upper arm remains stable in the shoulder socket during work, sport and functional activities.
Bursae that are not infected can be treated symptomatically with rest, ice, elevation, physiotherapy , anti-inflammatory drugs and pain medication. Since bursitis is caused by increased friction from the adjacent structures, a compression bandage is not suggested because compression would create more friction around the joint. Chronic bursitis can be amenable to bursectomy and aspiration.  Bursae that are infected require further investigation and antibiotic therapy. Steroid therapy may also be considered.  In cases when all conservative treatment fails, surgical therapy may be necessary. In a bursectomy the bursa is cut out either endoscopically or with open surgery. The bursa grows back in place after a couple of weeks but without any inflammatory component.