Bursitis, tendinitis and rotator cuff problems are usually caused by two things: trauma (such as a fall, overuse or other injury) and misalignment. The problem is your shoulder is naturally more 'unstable' to begin with. After a trauma or injury, the shoulder can become 'sloppy.' It doesn't move correctly in the socket--this irritates nerves and un-balances muscles which causes pain, inflammation, stiffness, and weakness. Eventually, your shoulder may feel "feel better" but never completely heals.
Correcting this problem is more complex than taking anti-inflammatory medication or getting a steroid shot. The good news is most people with shoulder pain don't need surgery to eliminate their pain and use their shoulder normally again.