Bursitis

There are fluid-filled sacs sitting around your joints to help protect the tissues that slide over your bones when you move. These fluid-filled sacs are called bursa (singular) or bursae (plural). There are over 150 of these in your body but you won't be aware of them. They act as lubricants for your bones and the soft tissues around them, and help reduce friction when you move your joint. Bursitis is the inflammation of these bursae.

Acute and chronic describe how quickly bursitis starts and how it develops.

• Acute bursitis starts suddenly, often from injury, infection, or gout crystals. You feel sharp pain when pressing the area or moving the joint.
• Chronic bursitis develops slowly, usually from overuse or repeated pressure. It often causes painless swelling and thickening.

Common causes of bursitis include:

• repetitive movement of a certain joint, such as when you kneel a lot with work or hobbies (eg, carpet fitters, cleaners and carpenters)
• too much pressure on your joint, such as leaning on your elbows to work or study
• inflammatory conditions such as gout or rheumatoid arthritis
• an injury near your bursa
• an infection from your skin or near your joint.

Bursitis commonly affects your feet, shoulders, elbows, knees and hips. However, you can get bursitis in any joint. 

Common types of bursitis include:

• subacromial bursitis – this causes shoulder pain 
• olecranon bursitis – this causes elbow pain and is also known as student's elbow
• prepatellar bursitis – this causes knee pain and is often called housemaid's knee
• greater trochanteric pain syndrome – this causes hip pain
• retrocalcaneal bursitis – this affects your heel near the Achilles tendon and is found in athletes
• septic bursitis – this is caused by a bacterial infection and may occur in any joint. 
  
  

Image credit: Freepik

Symptoms of bursitis include:

• pain around your joint, which may or may not get worse when you move it
• swelling around your joint
• your affected joint feeling stiff
• restricted movement in a joint
• redness on the skin around your joint
• the skin around your joint feeling hot.

Your healthcare provider will ask you questions about your joint pain and work or hobbies that make you more likely to get bursitis. They’ll also ask whether you have any other medical conditions such as gout or rheumatoid arthritis and check whether you have other symptoms.

Your healthcare provider will also examine your joints. They may also send you for an X-ray or ultrasound scan, order blood tests or take a sample of fluid from your joint swelling using a needle, depending on what they think is the cause. Taking a fluid sample can help diagnose infection or gout arthritis.

You can usually manage bursitis yourself at home (self-care) with the following: 

• Rest as much as you can and avoid pressure, activities or repetitive movement that make your symptoms worse. However, don't stop moving the joint completely as you could lose muscle mass and get long-term stiffness in your joint. 
• Use ice to help reduce swelling in your joint and ease pain. You can wrap some ice or an ice pack in a towel and place it on your affected joint for 10 to 20 minutes. Repeat every few hours during the day. 
• Take pain relief medicines such as paracetamol or non-steroidal anti-inflammatory medicines (NSAIDs) such as ibuprofen. Ask your healthcare provider or pharmacist if it's okay for you to take NSAIDs. 
• Use pads and cushions to help protect your affected joint. 
• Wear comfortable, supportive shoes. Shoe inserts may also be helpful.
• Lose weight if appropriate.

You may need to see your healthcare provider if your bursitis is caused by an infection, as antibiotics are needed to treat that. 

See your healthcare provider if you experience the following:

• your symptoms don't improve or get worse after self-care measures for a few weeks
• you have a high temperature or fever, and you feel hot and shivery
• you can't move your affected joint
• you have very severe pain in your joint
• you have significant swelling, bruising or a rash over the affected joint.
  
  

Image credit: Healthify He Puna Waiora

Apps reviewed by Healthify

You may find it useful to look at some joint and bone health apps.

Beyond self-care, other treatments for bursitis include the following:

• Orthotics – special devices designed to protect a joint.
• A steroid injection – some types of bursitis can be treated by injection with steroids into your affected joint to help reduce inflammation, but not all types of bursitis can be treated with this. This is usually done shortly after fluid has been removed.
• Physiotherapy – a physiotherapist can teach you suitable exercises to improve your joint movements and strengthen the muscles and soft tissues that support your joints to prevent injuries. Ask your healthcare provider to find out whether you need to be referred to a physiotherapist or you can find a private physiotherapist(external link). 
• Surgery – surgery is rarely needed to remove your bursa unless you keep getting bursitis.

Bursitis should go away in a few weeks with self-care. See your healthcare provider if your symptoms haven't improved and are getting worse after treating it yourself. 

You can prevent bursitis by:

• maintaining good posture
• maintaining a healthy weight or losing weight if you're overweight
• making sure any wound is clean if you have any cuts on your skin near a joint
• avoiding repetitive movements and taking frequent breaks – especially if hobbies or work require the same repetitive movements for long periods
• warming up properly before exercising or playing sports
• using pads or cushions to support your joints if you're putting a lot of pressure on them 
• avoiding positions that cause pain
• using a trolley or wheeled cart when carrying heavy loads
• using your knees when lifting
• treating any underlying condition affecting your bursitis. 

Remember: If it hurts, don’t do it.