Bursitis: Causes, Symptoms, Diagnosis, and Treatment

Bursitis is a common condition characterized by inflammation of a bursa, a small fluid-filled sac that helps reduce friction between bones, tendons, muscles, and skin near joints. Bursae act as cushions that allow smooth movement during joint activity. When these sacs become inflamed, they can cause pain, swelling, and limited joint motion. Bursitis most frequently affects the shoulder, elbow, hip, and knee, but it can occur near almost any joint in the body.

What Is a Bursa?

A bursa is a thin, lubricated sac filled with synovial fluid that acts as a protective cushion between moving structures in the body. These sacs help minimize friction when muscles and tendons slide over bones during movement. When excessive pressure, injury, or infection occurs, the bursa can become irritated and inflamed, leading to bursitis.

There are over 150 bursa throughout the human body, but only a few commonly become inflamed due to repetitive use or trauma.

Common Types of Bursitis

Bursitis is typically named after the affected joint or location. Some of the most common forms include:

1. Shoulder Bursitis (Subacromial Bursitis)

One of the most common types, often associated with rotator cuff irritation. It causes pain when lifting the arm or reaching overhead.

2. Hip Bursitis (Trochanteric Bursitis)

Inflammation of the bursa on the outer side of the hip. Pain is usually felt along the outside of the hip and thigh.

3. Elbow Bursitis (Olecranon Bursitis)

Also called “student’s elbow,” this occurs when the bursa at the tip of the elbow becomes swollen and tender.

4. Knee Bursitis (Prepatellar Bursitis)

Often referred to as “housemaid’s knee,” it is caused by prolonged kneeling or pressure on the knee.

5. Heel Bursitis (Retrocalcaneal Bursitis)

Occurs near the heel and may be associated with irritation from footwear or repetitive running.

Causes of Bursitis

Bursitis can develop due to several factors, including:

• Repetitive motion or overuse of a joint
• Direct trauma or injury to a joint
• Prolonged pressure on a specific area (such as kneeling or leaning on elbows)
• Infections (septic bursitis)
• Inflammatory diseases, such as rheumatoid arthritis or gout
• Poor posture or abnormal joint mechanics

Occupations or activities that involve repetitive movements—such as carpentry, gardening, sports, or manual labor—may increase the risk of developing bursitis.

Symptoms of Bursitis

Symptoms may vary depending on the affected joint but commonly include:

• Localized pain around the joint
• Swelling and tenderness
• Limited range of motion
• Warmth or redness over the affected area
• Pain during movement or pressure

In cases of infected (septic) bursitis, symptoms may also include fever, increased redness, and severe swelling.

Diagnosis

A healthcare provider typically diagnoses bursitis through a combination of:

• Medical history and physical examination
• Imaging studies, such as X-rays, ultrasound, or MRI to rule out other conditions
• Fluid aspiration, where fluid from the bursa is tested if infection or gout is suspected
• Blood tests to evaluate underlying inflammatory diseases

Accurate diagnosis helps determine the appropriate treatment and rule out other joint disorders such as arthritis or tendon injuries.

Treatment Options

Treatment for bursitis focuses on reducing inflammation, relieving pain, and preventing recurrence.

1. Conservative Treatments

Most cases improve with non-surgical care, including:

• Rest and activity modification
• Ice therapy to reduce swelling
• Anti-inflammatory medications such as NSAIDs
• Physical therapy to improve flexibility and strengthen surrounding muscles
• Protective padding or braces

2. Medical Interventions

If symptoms persist, additional treatments may include:

• Corticosteroid injections to reduce inflammation
• Aspiration of excess fluid from the bursa
• Antibiotics if infection is present

3. Surgical Treatment

Surgery is rarely required but may be recommended in chronic or recurrent cases where conservative treatments fail. Procedures may involve removal of the inflamed bursa (bursectomy).

Prevention of Bursitis

Several strategies can help reduce the risk of developing bursitis:

• Avoid repetitive strain on joints
• Maintain good posture and body mechanics
• Take frequent breaks during repetitive activities
• Use protective pads when kneeling or leaning on elbows
• Perform regular stretching and strengthening exercises

Maintaining a healthy weight can also reduce stress on weight-bearing joints such as the hips and knees.

When to Seek Medical Attention

Medical evaluation is recommended if:

• • Pain persists for more than a few days
  • Swelling or redness worsens
  • Fever develops
  • Movement of the joint becomes severely limited

Early diagnosis and treatment can prevent complications and help restore normal joint function.

Conclusion

Bursitis is a manageable condition that results from inflammation of the protective bursae around joints. Although it can cause discomfort and limit mobility, most cases respond well to conservative treatments such as rest, physical therapy, and anti-inflammatory medications. With proper care, lifestyle adjustments, and timely medical evaluation, individuals with bursitis can effectively control symptoms and return to their normal activities.