Bursitis is a painful inflammation of a bursa, a small fluid‑filled sac that cushions bones, tendons and muscles near joints. It most often shows up around the shoulder, hip, elbow or knee and can turn everyday motions into a chore.
TL;DR - Quick Takeaways
- Inflammation of a bursa causes localized pain and swelling.
- Common triggers: repetitive motion, direct trauma, infection or systemic diseases like rheumatoid arthritis.
- Symptoms include tender swelling, limited range of motion and a dull ache that worsens with pressure.
- First‑line treatment: rest, ice, NSAIDs and gentle stretching.
- If symptoms persist, options expand to corticosteroid injections, aspiration or guided ultrasound imaging for precise diagnosis.
What Exactly Is a Bursa?
A bursa is a thin, fibrous sac lined with a synovial membrane that secretes synovial fluid. This fluid acts like a lubricant, allowing tendons and muscles to glide smoothly over bone. When a bursa becomes irritated, the fluid volume spikes, leading to swelling and the hallmark ache of bursitis.
Key Causes of Bursitis
Understanding why bursitis develops helps you avoid the trigger. The main culprits fall into three buckets:
- Mechanical stress: Repeating the same motion-think of a carpenter hammering or a tennis player serving-creates micro‑trauma. Overuse of the prepatellar bursa (the “house‑knees” bursa) is classic for people who kneel a lot.
- Acute injury: A direct blow can bruise a bursa, prompting sudden swelling. A fall onto the elbow often inflames the olecranon bursa.
- Systemic or infectious factors: Conditions like rheumatoid arthritis or gout make bursae more reactive. Rarely, bacteria can seed a bursa after a cut, leading to septic bursitis that needs antibiotics.
Occupational overuse-such as painters constantly reaching overhead-often targets the trochanteric bursa on the hip, causing the classic “greater trochanteric pain syndrome.”
Spotting the Symptoms
Symptoms vary by location but typically include:
- Localized tenderness that gets worse when you press on the joint.
- Visible swelling or a “boggy” feel under the skin.
- Reduced range of motion-raising the arm overhead or walking up stairs can become painful.
- A dull, aching background pain that may flare after activity.
In septic cases, the area may feel warm, red and feverish, signalling an infection that needs urgent care.
How Doctors Diagnose Bursitis
Clinical examination is the first step. Your clinician will press around the joint to locate the painful bursa and assess movement. To confirm the diagnosis and rule out other issues (like a tendon tear), imaging often follows:
- Ultrasound imaging shows fluid accumulation in real time and guides needle procedures.
- MRI provides a detailed look at surrounding soft tissue, useful when the cause isn’t clear.
- In suspicious infection, a sample of the fluid-obtained via aspiration-is sent for culture.
Treatment Options - What Works Best?
Most cases respond to conservative care. Below is a side‑by‑side look at the most common approaches.
| Treatment | Effectiveness (mild‑moderate) | Onset of Relief | Typical Side Effects | Duration of Use |
|---|---|---|---|---|
| Rest & Ice | High (when applied early) | Immediate to 48hrs | None | 1‑2weeks |
| NSAIDs (e.g., ibuprofen) | Moderate‑High | 12‑24hrs | GI irritation, renal strain | Up to 3weeks |
| Physical therapy (stretching, strengthening) | High (prevents recurrence) | 1‑2weeks | Transient soreness | 4‑6weeks |
| Corticosteroid injection | Very High (severe cases) | Within days | Skin thinning, temporary flare | Single‑dose; repeat after 3months if needed |
| Surgery (bursectomy) | High (chronic, refractory) | Weeks (post‑op) | Infection, scar tissue | Recovery 6‑12weeks |
Quick relief usually starts with ice, rest and NSAIDs. If swelling persists beyond a week, many clinicians add a corticosteroid injection under ultrasound guidance. Physical therapy isn’t just a secondary step-it’s crucial for restoring strength and preventing the bursa from inflaming again.
Practical Self‑Care Tips
- Apply a cold pack for 15‑20 minutes, three times a day during the first 48hrs.
- Elevate the affected limb when possible to reduce fluid buildup.
- Take an NSAID with food to protect your stomach.
- Begin gentle range‑of‑motion exercises after the acute pain eases; a physiotherapist can demonstrate safe moves.
- Modify activities-use padded knee sleeves for kneeling jobs or ergonomic tools for overhead work.
When to Seek Professional Help
Most bursitis resolves in two weeks, but call a health professional if you notice any of these red flags:
- Heat, redness or fever-possible septic bursitis.
- Pain that doesn’t improve after several days of rest and NSAIDs.
- Severe limitation that hampers daily tasks (e.g., unable to lift your arm).
- History of gout, rheumatoid arthritis or chronic steroid use.
Early intervention with aspiration and antibiotics can stop an infection from spreading to surrounding tissue.
Related Conditions You Might Encounter
People often mix up bursitis with:
- Tendinitis-inflammation of a tendon rather than the bursa.
- Joint arthritis-affects the cartilage, not the cushioning sack.
- Stress fracture-tiny bone cracks that also cause localized pain.
Distinguishing them matters because treatment pathways differ. For example, tendinitis may respond better to eccentric loading exercises, while arthritis often needs disease‑modifying drugs.
Next Steps in Your Bursitis Journey
Now you’ve got the basics: cause, signs and a toolkit of treatments. The logical follow‑up topics to explore are:
- "How to Choose the Right Physical Therapy Program for Bursitis"
- "Understanding Corticosteroid Injections: Benefits and Risks"
- "Preventing Recurrent Bursitis in Active Occupations"
Each deep‑dives will help you fine‑tune recovery and keep future flare‑ups at bay.
Frequently Asked Questions
Can bursitis heal on its own without medication?
Yes, many mild cases resolve with rest, ice and activity modification. The body re‑absorbs excess fluid, and the inflammation subsides within 1‑2 weeks. However, if pain persists, a short course of NSAIDs or a guided injection often speeds recovery.
Is it safe to keep exercising when I have bursitis?
Gentle motion is usually encouraged to prevent stiffness, but high‑impact or repetitive motions that aggravate the bursa should be avoided. A physiotherapist can design a low‑stress program that keeps muscles active without overloading the inflamed sac.
What’s the difference between septic and non‑septic bursitis?
Non‑septic bursitis is caused by mechanical irritation or systemic inflammation; it’s not infectious and responds to anti‑inflammatories. Septic bursitis occurs when bacteria enter the bursa, often after a skin break. It presents with warmth, redness and fever, and requires antibiotics plus possible drainage.
How long does a corticosteroid injection last?
The anti‑inflammatory effect can begin within a few days and may last 4‑6 weeks. Some patients need a repeat injection after three months, but doctors limit frequency to avoid tendon weakening.
Can I use heat instead of ice?
During the first 48‑hours, ice is preferred because it constricts blood vessels and reduces swelling. Heat can be introduced later (after the acute phase) to relax muscles before stretching exercises.
Is surgery ever necessary for bursitis?
Surgery, typically a bursectomy, is reserved for chronic bursitis that fails all conservative measures or for recurrent septic cases. Most patients avoid surgery by following a disciplined rehab plan.