Thank you Ginger...Most definitely spinal mechanisms have got to be assessed to rule out this as a cause. My experience so far tells me that bursitis is not a standalone pathology. Infact, if this is occuring then something predisposes to it. it may be arthritis, muscle imbalance or primary tendon issues/over use. It just gets complicated when there is a combined spinal problem and you have a referred pattern but bursitis can exist and when we examine a patient localised movement of the joint in question, behaviors at night, inability to rest on the affected part would suggest so. Also when we palpate we might have an incline to this. Often enough, symptomatic management, attempting to corect predisposing factors are the means of managing.recently seeing a man who is suffering from Wikipedia reference-linkrotator cuff lesion now with an inflammed subacromial bursa, he however has some symptoms suggesting C6 involvement but his shoulder issues are definite.

If the treating therapist is unsure, an Wikipedia reference-linkMRI or CT scan can be requested to clarify. So Ginger, in your experience have you had to manage busitis specifically or all ur cases have truly been spinal with no physical evidence (with regards examination) of bursitis?