Bursitis is a painful swelling of the bursae, the fluid-filled sacs that support the joints and reduce friction between tendons, muscles, and bones near the joints. Bursitis occurs when these sacs become inflamed, usually because of repetitive movements that put stress on the joints.
Bursitis most commonly affects the shoulders, elbows, and hips. It can also occur in your knees, ankles, and big toes. With proper treatment, bursitis often goes away within a few weeks, but it can flare up from time to time.
Bursitis can be acute (short-term) or chronic (long-term with repeated flare-ups). There are over 150 bursae in your body. Bursitis can develop in any of them. As mentioned, it’s most common in joints that you put a lot of strain on, either from pressure or repetitive movements. The most common types of bursitis include:
Ischial bursitis: Occurs in your buttocks
Olecranon bursitis: Occurs in your elbows
Prepatellar bursitis: Occurs in your knees
Subacromial bursitis: Occurs in your shoulders
Trochanteric bursitis: Occurs in your hips
It’s also very common for bursitis to develop in the feet, especially near the big toes, balls of the feet, or heels. One example is anterior (front) or posterior (back) Achilles tendon bursitis, which develops near the Achilles tendon, which is located on the back of the lower leg, above the heel bone.
Bursitis is also classified by cause:
Septic bursitis: Caused by an infection. The most common cause of septic bursitis is Staphylococcus aureus (a staph infection).
Aseptic bursitis (also known as traumatic bursitis): Caused by trauma, such as repetitive motion or pressure
If you have bursitis, your affected joint may:
Feel stiff and achy
Have increased pain when you move it or press on it
Look red and swollen, especially if the inflamed bursae are close to the skin
If your bursitis is caused by an infection, you may also have:
Warmth or heat coming from the affected joint
Redness or discoloration of the skin
Fever
Chills
Any of these symptoms warrant a doctor’s visit, but this is especially true if you:
Have joint pain that feels disabling
Feel suddenly unable to move a joint
Have significant redness, swelling, or bruising in the affected area
Feel sharp, shooting pain in the joint, especially during exertion or exercise
Have a fever
The most common causes of bursitis are repetitive movements or maintaining positions that put pressure on certain joints. Examples include:
Lifting heavy boxes or other objects over your head repeatedly
Leaning on your elbows for extended periods of time, such as resting them on a desk
Kneeling for long periods without adequate padding, such as when scrubbing floors or laying carpet
Having scleroderma (an autoimmune disease causing chronic hardening of the skin)
Having spondyloarthropathy (inflammatory diseases that mainly affect the spine and joints)
Risk Factors for Bursitis
Anyone can develop bursitis, but you are more likely to get bursitis if you:
Are an athlete
Have a job involving physical labor
Play an instrument
Have certain health conditions, such as arthritis, diabetes, or thyroid disease
The first step in diagnosing bursitis is a physical exam performed by your healthcare provider. Your doctor will examine the affected joint and ask you questions about your symptoms. Be sure to tell them if your job or hobbies require repetitive movements like lifting boxes or pressure on your joints.
Based on the findings of your physical exam, your provider may order certain tests to help diagnose bursitis. These tests may include:
X-ray: An X-ray can help rule out other possible causes of your symptoms.
Magnetic resonance imaging (MRI) or ultrasound: These tests can identify swollen bursae.
Blood test: These tests can identify an infection.
Aspiration: This involves obtaining a sample of the fluid if your doctor thinks your bursitis may be caused by an infection.
Most cases of bursitis go away on their own after a few weeks with nothing more than a little rest for the area. Be sure to avoid the repetitive movements and pressure that likely caused your bursitis, and let your body heal. Your doctor will let you know how long you need to rest the joint.
Your provider may recommend at-home treatments during your healing period to help ease the pain and swelling you feel. These may include:
Elevation of the affected joint
Over-the-counter (OTC) pain relievers, such as acetaminophen or ibuprofen for a short time, as recommended by your provider
Ice on the bursae for 15 minutes at a time, a few times per day
Heat, such as a heating pad, on the area
A splint, sling, or brace to immobilize the area and allow for rest
In some cases, your doctor may also recommend other treatment options, such as:
Physical therapy: This intervention can help increase your range of motion (how far you can move your joint).
Occupational therapy: This intervention can teach you safe ways to move your joints to prevent further injury.
Assistive device: It could help to temporarily use an assistive device like a walking cane to relieve pressure in the affected area.
Antibiotics:Antibiotics may be necessary if you have septic bursitis.
Corticosteroid injections:Corticosteroid injections can decrease inflammation and pain in the bursae.
Repeated aspiration: If you have septic bursitis, repeated removal of infected fluid from the bursae with a needle may be necessary.
Surgery: Surgical drainage and removal of the bursae (known as a bursectomy) may be needed if they don’t heal with other therapies and if you’ve been experiencing symptoms for at least six months. This is most common with septic bursitis.
The best way to prevent bursitis is to avoid overusing your joints. To prevent bursitis, it can help to:
Ensure you’re at a healthy weight.
Use proper posture and techniques when performing work or hobby activities.
Consider using a dolly or wheeled cart to move heavy loads rather than lifting them.
Take breaks.
Use cushions when you kneel or lean on your elbows.
Exercise regularly to strengthen your muscles and protect the affected joint, but be sure to ease into any new exercise or activity to avoid injury.
Stretch and warm up properly before exercise or other strenuous activities to reduce your risk of injury.
Avoid sitting or kneeling for long periods, as this puts a lot of pressure on your joints.
Take frequent breaks if you are performing a repetitive task.
Bursitis usually doesn’t last long. Most people recover within a few weeks. That said, it’s not uncommon for bursitis to flare up from time to time. Make sure to follow your doctor’s recommendations and don’t resume activities until your bursitis is completely healed to avoid complications or further injury.
Bursitis is usually short-lived, but complications can occur, especially if the area is not given enough time to heal.
If you return to activities that put pressure and strain on your injured bursae, you may develop complications such as chronic bursitis. Recurrent flare-ups can damage your bursae, leading to reduced mobility in the affected joint.
Bursitis is a common cause of chronic pain. In general, it happens equally among men and women. It can happen at any age, but it’s most common in older adults. That’s because older adults are more likely to be affected by conditions like osteoarthritis than younger adults. It’s also more common among people with obesity, who have manual labor jobs, or are athletes.
Septic bursitis in particular is more common in people who are immunocompromised, such as those with diabetes or rheumatic conditions.
Because bursitis involves inflammation, pain, and swelling near the joints, it shares some similarities with other conditions, such as arthritis and tendinitis.
Arthritis
Because arthritis and bursitis both affect the joints, the symptoms can sometimes look similar. But bursitis usually does not cause long-term damage to the joint unless you continue to put stress on the area. Symptoms are typically short-lived and heal within a few weeks. Arthritis, on the other hand, is a lifelong condition caused by the slow breakdown of cartilage in a joint over time.
Tendonitis
Tendonitis and bursitis both occur when tissues in your body become irritated, swollen, and inflamed. They’re also both caused by repetitive use and pressure.
But there’s a difference in which tissues are affected. Bursitis is inflammation of the bursae, and symptoms occur near the affected joint. Tendonitis is inflammation of the tendons, which are connective tissues between muscle and bone, and symptoms occur at the area of the affected tendon. Tendonitis can be either a short-term or long-term condition.
Bursitis is inflammation of the bursae (fluid-filled sacs that support the muscles, tendons, and bones near your joints).
When these sacs become damaged, it can cause irritation, swelling, and pain near the joint.
Repetitive pressure or movements are the leading cause of bursitis.
Most cases of bursitis go away in a few weeks with rest and at-home treatments, unless your bursitis becomes chronic or is caused by an infection.
