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Bursitis

Bursitis is the swelling and irritation of a bursa. A bursa is a fluid-filled sac that acts as a cushion between a muscles, tendons, and bones.

Causes

Bursitis is often a result of overuse. It can be caused by a change in activity level, such as training for a marathon or by being overweight.

It can also be caused by trauma, rheumatoid arthritis, gout, or infection. Sometimes the cause can't be found.

Bursitis commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the Achilles tendon and the foot.

Symptoms

Symptoms of bursitis may include any of the following:

  • Joint pain and tenderness when you press around the joint
  • Stiffness and aching when you move the affected joint
  • Swelling, warmth or redness over the joint
  • Pain during movement and rest
  • Pain may spread to the nearby areas

Exams and Tests

The health care provider will ask about your medical history and perform physical exam.

Tests that may be ordered include:

Treatment

Your provider will talk to you about a treatment plan to help you resume your normal activity.

Tips to relieve bursitis pain:

  • Use ice 3 to 4 times a day for the first 2 or 3 days.
  • Cover the painful area with a towel, and place the ice on it for 15 minutes. DO NOT fall asleep while applying the ice. You can get frostbite if you leave it on too long.
  • When sleeping, do not lie on the side that has bursitis.

For bursitis around the hips, knees, or ankle:

  • Try not to stand for long periods.
  • Stand on a soft, cushioned surface, with equal weight on each leg.
  • Placing a pillow between your knees when lying on your side can help decrease pain.
  • Flat shoes that are cushioned and comfortable often help.
  • If you are overweight, losing weight may also be helpful.

You should avoid activities that involve repetitive movements of any body part when possible.

Other treatments include:

  • Medicines such as NSAIDs (ibuprofen, naproxen)
  • Physical therapy
  • Exercises you do at home to build strength and keep the joint mobile as pain goes away
  • Removing fluid from the bursa and getting a shot of corticosteroid

As the pain goes away, your provider may suggest exercises to build strength and keep movement in the painful area.

In rare cases, surgery is done.

Outlook (Prognosis)

Some people do well with treatment. When the cause cannot be corrected, you may have long-term pain.

Possible Complications

If the bursa is infected, it becomes more inflamed and painful. This usually requires antibiotics or surgery.

When to Contact a Medical Professional

Call your provider if symptoms recur or do not improve after 3 to 4 weeks of treatment, or if the pain is getting worse.

Prevention

When possible, avoid activities that include repetitive movements of any body parts.

Alternative Names

Student's elbow; Olecranon bursitis; Housemaid's knee; Prepatellar bursitis; Weaver's bottom; Ischial gluteal bursitis; Baker's cyst; Gastrocnemius - semimembranosus bursa

References

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders of sports medicine. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 263.

Schmidt MJ, Adams SL. Tendinopathy and bursitis. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 117.

Review Date 9/22/2016

Updated by: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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