Bursitis

What is Bursitis?

Bursitis is inflammation of the bursae, small fluid-filled sacs that cushion the bones, tendons, and muscles near your joints. These sacs reduce friction and allow smooth movement. When a bursa becomes inflamed, movement becomes painful.

Your body has over 150 bursae. The most commonly affected areas include:

• Shoulder (subacromial bursitis)
• Hip (trochanteric bursitis)
• Knee (prepatellar bursitis, or “housemaid’s knee”)
• Elbow (olecranon bursitis)
• Heel (retrocalcaneal bursitis)

Bursitis can develop suddenly from injury or gradually from repetitive stress. Most cases resolve within a few weeks with proper treatment, though some become chronic.

Types of Bursitis

By Location

Shoulder Bursitis (Subacromial)

• Most common type
• Pain with overhead reaching
• Difficulty sleeping on affected side
• Often occurs with rotator cuff problems

Hip Bursitis (Trochanteric)

• Pain on outer hip that may radiate down thigh
• Worse when lying on affected side
• Pain climbing stairs or after prolonged sitting
• Common in runners and cyclists

Knee Bursitis (Prepatellar)

• Swelling on front of kneecap
• Pain with kneeling or bending
• Often affects those who kneel frequently
• Also called “housemaid’s knee” or “carpet layer’s knee”

Elbow Bursitis (Olecranon)

• Visible swelling at tip of elbow
• May develop after trauma or prolonged leaning
• Usually not very painful unless infected

By Cause

Traumatic Bursitis

• Results from direct injury or blow
• Causes bleeding into the bursa
• Often has sudden, severe onset

Chronic/Overuse Bursitis

• Develops from repetitive motion
• Gradual onset over weeks or months
• Most common type

Septic Bursitis

• Bacterial infection of the bursa
• Requires immediate medical attention
• Signs: fever, severe pain, spreading redness, warmth

Symptoms to Watch For

Common Symptoms

• Localized pain that worsens with movement or pressure
• Swelling visible or palpable near the joint
• Stiffness especially after periods of rest
• Tenderness when touching the affected area
• Limited range of motion due to pain

Warning Signs (Seek Immediate Care)

• Fever accompanied by joint pain
• Rapidly increasing swelling
• Redness spreading from the joint
• Severe pain preventing all movement
• Joint warmth with systemic illness

Causes and Risk Factors

Common Causes

• Repetitive motion: Throwing, painting, gardening, typing
• Prolonged pressure: Kneeling, leaning on elbows
• Acute injury: Falls, blows to the joint
• Underlying conditions: Arthritis, gout, thyroid disorders
• Infection: Usually from skin bacteria entering through cuts

Who’s Most at Risk?

• Workers with repetitive job tasks (carpenters, plumbers, musicians)
• Athletes, especially runners, swimmers, and tennis players
• People with inflammatory arthritis
• Those with previous bursitis episodes
• Individuals over age 40

Diagnosis

Physical Examination

• Assessment of pain location and character
• Range of motion testing
• Palpation of affected bursa
• Evaluation for signs of infection

Imaging Studies

• X-rays: Rule out other conditions like arthritis or fractures
• Ultrasound: Visualize bursal swelling and guide treatment
• MRI: Evaluate soft tissue when diagnosis is unclear

Fluid Analysis

• If septic bursitis suspected, fluid may be aspirated and tested
• Analyzes for bacteria, crystals (gout), and cell counts

Treatment Options

Self-Care Measures

Most bursitis improves with conservative treatment:

• Rest: Avoid activities that worsen symptoms
• Ice: Apply for 15-20 minutes several times daily
• Compression: Elastic bandage to reduce swelling
• Elevation: When possible, keep affected area elevated
• Padding: Protect joints from further pressure

Medications

• Over-the-counter NSAIDs: Ibuprofen, naproxen for pain and inflammation
• Topical anti-inflammatories: Creams and gels applied directly
• Prescription medications: Stronger anti-inflammatories if needed
• Antibiotics: Essential for septic bursitis

Corticosteroid Injections

For persistent bursitis not responding to conservative measures:

• Reduce inflammation quickly and effectively
• Provide relief lasting weeks to months
• Usually combined with local anesthetic
• May be repeated if needed, with limits to prevent tissue damage

Physical Therapy

• Stretching exercises to restore flexibility
• Strengthening exercises for surrounding muscles
• Activity modification education
• Ergonomic assessment for work-related causes

Surgical Treatment (Rare)

• Reserved for chronic bursitis failing all other treatments
• Involves removing the inflamed bursa
• Bursa typically regenerates in a healthier state

Prevention Strategies

Protect Your Joints

• Use knee pads when kneeling
• Take frequent breaks during repetitive tasks
• Cushion your elbows when leaning on hard surfaces
• Maintain proper posture and body mechanics

Strengthen and Stretch

• Regular stretching keeps tissues flexible
• Strong muscles better support joints
• Warm up before physical activity

Lifestyle Modifications

• Maintain healthy weight to reduce joint stress
• Vary your activities to prevent overuse
• Address underlying conditions like arthritis

Questions to Ask Your Healthcare Provider

1. What’s causing my bursitis, and how can I prevent recurrence?
2. Is imaging needed to confirm the diagnosis?
3. Should I see a physical therapist?
4. When would a cortisone injection be appropriate?
5. How long should I rest before returning to activities?
6. Could an underlying condition be contributing?

Related Resources

• Cortisone Injections for Joint Pain
• Physical Therapy for Joint Conditions
• Understanding Shoulder Osteoarthritis
• Hip Arthritis Guide