Bursitis: Causes, Symptoms, and Treatment
What Is Bursitis?
Bursitis is inflammation of a bursa, a small fluid-filled sac that sits between tendons, muscles, and bones and cushions the joints. It most often affects the shoulder, elbow, hip, and knee. Bursitis is a common condition. It affects people of all ages, though older adults may be at greater risk, and it is frequent among people whose work or daily activities involve repetitive movement or sustained pressure on a joint.
Causes and Risk Factors
Several mechanisms can trigger bursitis:
- Repetitive movements or sustained postures that overload a joint (throwing sports, carrying heavy loads)
- Direct trauma, such as a fall or a blow to the joint
- Bacterial infection (septic bursitis), most often a staph infection that enters through a break in the skin
- Chronic inflammatory conditions such as rheumatoid arthritis, gout, or pseudogout (crystal deposits)
- Occupational factors involving repeated pressure or kneeling (plumbers, tile setters, HVAC technicians, athletes)
Symptoms
Symptoms vary by location and cause, but the most common are:
- Localized pain, often sharp, that worsens with movement and pressure
- Swelling around the affected joint
- Redness and local warmth with acute inflammation or infection
- Stiffness that limits range of motion
- Tenderness to the touch, sometimes with a soft, palpable lump
- In severe cases, fever and other systemic signs (septic bursitis)
Diagnosis
Bursitis is diagnosed mainly through a physical exam: the doctor reviews your history and examines the joint for tenderness and characteristic swelling. Additional tests may be ordered:
- Ultrasound to visualize fluid buildup
- X-ray to rule out a fracture or associated arthritis
- MRI if the diagnosis is unclear
- Fluid aspiration from the bursa to check for infection or crystals
Treatments
Treatment depends on the cause and severity:
- Rest and offloading the affected joint, pausing the activity that triggered it
- NSAIDs such as ibuprofen, in a short course, to ease pain and swelling
- Ice applied to the affected joint to ease pain and swelling
- Corticosteroid injection into the bursa, given by a doctor, for stubborn cases
- Antibiotics, oral or intravenous, for septic bursitis
- Physical therapy and strengthening exercises to prevent recurrence
- Aspiration to drain a significant fluid buildup
- As a last resort, surgery (bursectomy) for disabling chronic bursitis
Prevention
A few habits lower the risk of bursitis:
- Use proper technique in sports and at work, and avoid excessive repetitive movement
- Warm up before physical activity and recover properly afterward
- Wear appropriate protective equipment (knee pads, elbow pads) in higher-risk jobs
- Maintain a healthy weight to reduce stress on the hip and knee
- Strengthen the muscles around the joint with a regular exercise program
- Set up your workstation ergonomically to limit strenuous postures
When Should You See a Doctor?
See a doctor promptly if joint pain is intense, swelling is significant or growing quickly, a fever develops (a possible sign of infection), or symptoms last more than a week despite rest. A red, warm, and painful joint needs urgent medical evaluation.
Sources
- MedlinePlus, U.S. National Library of Medicine health information
- NIAMS, National Institute of Arthritis and Musculoskeletal and Skin Diseases
- OrthoInfo (AAOS), American Academy of Orthopaedic Surgeons patient education
- Bursitis (StatPearls, NCBI Bookshelf), that bursitis is a common condition affecting all ages with greater risk in older adults and in repetitive-movement occupations
- Septic Bursitis (StatPearls, NCBI Bookshelf), that Staphylococcus aureus is the most common organism in septic bursitis and that bacteria enter through trauma or puncture of the overlying skin