Bursitis

Overview

Bursitis is inflammation or irritation of a bursa, a small fluid-filled sac that helps reduce friction between bones, tendons, muscles and skin. Bursae act like cushions around many joints, especially in areas that move frequently or carry pressure. When a bursa becomes inflamed, movement can become painful and the affected area may feel tender or swollen.

Bursitis most often affects the shoulder, elbow, hip, knee, heel or the area around the base of the big toe. It may develop suddenly after an injury or gradually due to repeated movements or prolonged pressure. In many cases, bursitis improves with appropriate medical guidance and activity modification, but some cases can persist or return if the underlying cause is not addressed.

Symptoms

The symptoms of bursitis can vary depending on the joint involved and the severity of inflammation. Common symptoms include:

• Pain around a joint, especially during movement or when pressure is applied
• Tenderness over the affected area
• Swelling or a visible lump near the joint
• Warmth or redness over the skin in some cases
• Stiffness or reduced range of motion
• Pain that worsens with repeated activity, kneeling, leaning on the elbow or lifting the arm

Shoulder bursitis may cause pain when raising the arm or lying on the affected side. Hip bursitis may cause pain on the outside of the hip, often worse with walking, climbing stairs or lying on that side. Elbow or knee bursitis may cause noticeable swelling, particularly after pressure on the area.

If bursitis is related to infection, the area may become increasingly red, hot, swollen and very painful, sometimes with fever or general unwellness. This situation requires prompt medical attention.

Causes and Risk Factors

Bursitis usually develops when a bursa is irritated by repeated movement, pressure, injury or inflammation. Common causes include repetitive tasks, sports activities, prolonged kneeling, frequent overhead arm movements or leaning on the elbows for long periods.

Risk factors for bursitis include:

• Occupations or hobbies involving repeated joint movements
• Sports that place repeated stress on the shoulders, hips, knees or elbows
• Poor posture or altered movement patterns
• Direct injury or trauma to a joint
• Prolonged pressure on a joint, such as kneeling or resting on elbows
• Age-related changes in tendons and joints
• Underlying joint conditions such as arthritis
• Metabolic or inflammatory conditions that may affect joints and soft tissues
• Infection, particularly when the skin over a bursa is broken

Not all joint pain is bursitis. Similar symptoms may occur with tendon problems, arthritis, muscle strains, nerve irritation or other orthopedic conditions. A medical assessment helps identify the correct cause.

Diagnosis

Diagnosis of bursitis usually begins with a discussion of symptoms, medical history, recent activities, work habits, sports participation and any injury. An orthopedic specialist or other healthcare professional will examine the affected area, checking for tenderness, swelling, warmth, movement limitation and signs of infection.

In many cases, bursitis can be suspected based on the history and physical examination. Imaging may be used when symptoms are persistent, severe, unclear or associated with an injury. Ultrasound can help show fluid or inflammation in a bursa. X-rays do not show bursae directly but may help rule out bone problems, arthritis or other joint conditions. Magnetic resonance imaging may be considered in selected cases when deeper structures need to be assessed.

If infection is suspected, the doctor may recommend blood tests or may take a sample of fluid from the swollen bursa for laboratory examination. This helps distinguish non-infectious inflammation from infection and guides appropriate care.

Treatment Options

Treatment depends on the location, cause and severity of bursitis, as well as whether infection is present. The main goals are to reduce pain and inflammation, protect the affected area and address the activity or condition that triggered the problem.

Non-surgical treatment is usually the first approach. This may include temporary reduction of activities that aggravate symptoms, protective padding, changes in posture or technique, and guided rehabilitation exercises to improve flexibility, strength and joint mechanics. A healthcare professional may recommend physical therapy, especially when bursitis is related to movement patterns, muscle weakness or sports activity.

Cold or heat applications may be discussed as part of symptom management, depending on the stage and nature of the condition. Pain-relieving or anti-inflammatory medicines may be considered by a doctor, taking into account the patient’s overall health, other medical conditions and possible side effects.

In some cases, a doctor may remove excess fluid from a swollen bursa, particularly if infection needs to be ruled out or swelling is significant. Injections may be considered for selected non-infectious cases when symptoms do not improve with initial care. If bursitis is caused by infection, medical treatment is necessary and should not be delayed.

Surgery is rarely needed, but it may be discussed for chronic or recurrent bursitis that does not respond to other treatments, or when there are complications. The best treatment plan is individualized after medical evaluation.

When to See a Doctor

Medical evaluation is recommended if joint pain or swelling is persistent, worsening, recurrent or interfering with daily activities, work or sleep. A doctor should also be consulted if symptoms follow an injury, if movement becomes significantly limited, or if there is uncertainty about the cause of pain.

Seek prompt medical attention if the affected area is very red, hot, rapidly swelling or severely painful, or if symptoms are accompanied by fever, chills or feeling unwell. These may be signs of infection or another condition requiring urgent care.

International patients experiencing bursitis symptoms can benefit from an orthopedic assessment to confirm the diagnosis, identify contributing factors and receive a safe, personalized treatment plan. Early evaluation may help prevent ongoing irritation and support a return to comfortable movement.