What Is Bursitis?
Bursitis is inflammation or irritation of a bursa sac. You have these sacs all over your body. They’re filled with fluid that eases rubbing and friction between tissues such as bones, muscles, tendons, and skin. Bursitis is common around major joints such as your shoulder, elbow, hip, or knee.
What Are Bursitis Causes and Risk Factors?
Bursitis is common in adults, especially after age 40.
It’s usually caused by repeated pressure on an area or by using a joint too much. High-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, playing tennis, golf, skiing, and throwing. You can also get bursitis by sitting or standing the wrong way for a long time at work or home, or by not stretching enough before you exercise. Sudden injury can sometimes cause bursitis.
As you age, your tendons aren’t able to handle stress as well. They’re less elastic and easier to tear.
If there’s a problem with the structure of a bone or joint (such as legs that are different lengths or arthritis in a joint), it can put more stress on a bursa, causing bursitis. Reactions to medications and stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, or thyroid disorders, may also raise your risk.
An infection, especially with Staphylococcus aureus bacteria, can sometimes cause bursitis.
What Are the Types of Bursitis?
Bursas are small sacs filled with fluid that help cushion your joints, bones, and muscles. Any bursa can become inflamed, but the most common places to have bursitis are in your shoulder, elbow, knee, hip, or foot.
Bursitis can happen suddenly, or it can be ongoing (chronic). When it comes on suddenly, it usually hurts to move your affected joint. With chronic bursitis, a bursa swells slowly, and you may or may not feel pain.
Sometimes, bursitis is caused by an infection. This is called septic bursitis, and it’s not as common. Your doctor will check to make sure you don’t have an infection.
Shoulder bursitis causes painful swelling in your shoulder that gets worse when you move it. This can be caused by an injury or bump. Some people’s shoulder bones are naturally shaped in a way that puts more pressure on the bursa. If your bones are shaped like this, you're more likely to get shoulder bursitis.
Depending on how bad the swelling is, you might not be able to move your shoulder, a condition called frozen shoulder. If it hurts too much to move your shoulder, you should see your doctor. They can do tests to find out if it’s bursitis or a different problem. They might recommend physical therapy for your shoulder or other treatments.
One of the most common places to get bursitis is the pointy part of your elbow. If you have elbow bursitis, the bottom of your elbow will be swollen, red, and painful, with pain that gets worse when you bend it. Because of the swelling, it can look like there’s a small ball under your skin. If the ball gets bigger, it can make it harder to move your elbow.
Leaning on your elbows a lot can lead to elbow bursitis. Plumbers, electricians, HVAC technicians, and other people who have to crawl into tight spaces for work are more likely to put pressure on their elbows as they do their jobs. This kind of bursitis is also called “students’ elbow” because many people lean on their elbows when they sit at a desk to write or use a computer.
Injuries or bumps can also cause elbow bursitis. You might not remember the injury because it can take at least a week for bursitis to start. Doctors don’t understand why, but people who get dialysis for kidney problems are more likely to get elbow bursitis.
You can wrap an elastic bandage around your elbow or wear elbow pads to help ease your pain. If you do work that puts pressure on your elbows, wearing elbow pads or using a padded mat can help you avoid bursitis.
There are many different parts of your knee that can get bursitis, including near your kneecap or on the inside of your knee. If your bursitis is in your kneecap, it’s more likely to be caused by an infection.
When you have bursitis, it often hurts to move or put pressure on your knee, and it can hurt if someone else touches it. Your knee might also feel warmer than the rest of your body, and it sometimes looks swollen or red.
Sometimes, knee bursitis comes on suddenly after an injury or bump to your knee. More often, it's caused by pressure on your knee joints over time, and the pain comes on slowly. Runners and people who kneel on the ground for work, such as landscapers, gardeners, and plumbers, are more likely to get knee bursitis.
If you do these kinds of work, you should wear knee pads or use a padded cushion or board under your knees, and take as many breaks as you can. Try not to squat or bend your knees for too long. Stretching your hamstrings and other muscles before you exercise can help prevent knee bursitis.
People who fall a lot, such as wrestlers and people who play sports like football, are also more likely to get knee bursitis because they are more likely to bump or land on their knees.
Your doctor will look at both your knees, even if only one knee hurts, to compare them to each other and figure out what’s wrong. They might tell you to wear a knee brace or wrap to help you heal and protect your knees in the future. Putting your knee up on a pillow can help the swelling go down.
You can get bursitis in the bony part of your hip that sticks out near your waist. If you have this kind of bursitis, you might feel pain in your hip or outer thigh. You can also get bursitis on the inside of your hip, which causes pain in your hip, crotch, or groin.
You might not see any swelling if you have bursitis in your hip, but it can be painful. At first, the pain often feels sharp, and then turns into an ache that spreads out across your hip. It might hurt more when you lay on your hip, walk up the stairs, squat, or stand up from sitting down.
You are more likely to get this kind of bursitis if you have problems with your back or hips, if you’ve had hip replacement surgery, or if you were born with one leg that’s a little shorter than the other. Exercises such as running, riding a bike, or climbing up stairs can irritate it. You have a bigger risk of getting hip bursitis if you have a job where you have to move heavy things or stand up for long periods (for example if you’re a cashier, warehouse worker, or server).
If you have hip bursitis, your doctor might tell you to walk with a cane or use crutches while it heals. They might watch you walk, sit, and stand, or even videotape you. This will help them teach you less painful ways of moving around or standing.
There are 33 joints in your feet, and many of these joints have bursa sacs to protect them. You can get bursitis in your feet if any of these bursa sacs get irritated. You might have bursitis around your Achilles tendon in the back of your foot, near your heel, in the ball of your foot, at the base of your toes, or in between the outside of your little toe and your ankle.
If you have foot bursitis, your foot might feel swollen, stiff, or painful. The pain might get worse when you walk, run, or stand on your tip-toes.
High heels and shoes that squish your feet or don’t fit you well can lead to bursitis. Athletes, dancers, and runners are more likely to get foot bursitis.
Wearing supportive shoes that fit you well and stretching your feet and legs before you exercise can help prevent bursitis.
If you have foot bursitis, your doctor might tell you to go to a podiatrist. A podiatrist is a doctor who takes care of feet and ankles. They might give you a piece of foam or plastic called an orthotic to put in your shoe to cushion your foot.
Other types of bursitis
You have about 150 bursas throughout your body. It’s not as common, but you can get bursitis in any of these bursas. Some other types of bursitis are:
This is when a bursa near the main muscle of your buttocks becomes inflamed. This type of bursitis is sometimes called “weaver’s bottom” or “tailor’s bottom” because it's more common in people who often sit on hard surfaces, such as the floor or chairs that are not padded.
This kind of bursitis can cause pain and aching in your buttocks and upper thighs. The pain is usually worse after you sit for a long time, stretch, or exercise. It might also hurt when you flex, extend, or move your hips.
You can use a donut-shaped pillow to make sitting more comfortable. A cold compress on the area can help you feel better.
What Are the Symptoms of Bursitis?
Pain is the most common symptom of bursitis. It might build up slowly or be sudden and severe, especially if you have calcium deposits in the area. You’ll probably feel it when you stretch or extend the joint, and you may have a limited range of motion even without pain.
Your joint might also be:
Call your doctor if you have:
- Fever (over 102 F or 38.89 C)
- Swelling, redness, and warmth in the area
- General illness or more than one area that hurts
- Trouble moving the joint
- Pain that lasts longer than 2 weeks
These could be signs of an infection or another problem that needs medical care right away.
How Do You Prevent Bursitis?
You can’t always prevent bursitis, but some steps can lower your risk.
- Use cushions or pads when you’re resting a joint on a hard surface (for example, if you’re kneeling or sitting).
- If you play sports, mix things up so you don’t make the same motions all the time. Warm up and stretch before you play, and always use proper form.
- Start slowly and easily when you’re trying a new exercise or sport. As you build strength, you can use more force and do the motion more often.
- Don’t sit still for a long time.
- Take breaks often when you’re making the same motions over and over again.
- Maintain good posture all day.
- Hip bursitis can come from having one leg longer than the other. An orthotic shoe insert can help.
- Keep a healthy body weight.
- If something hurts, stop doing it and check with your doctor.
How Is Bursitis Diagnosed?
Your doctor will ask about your symptoms and do a physical exam to see if the joint is swollen. You might also have tests including:
- Imaging tests. X-rays can rule out other problems that might be causing pain. MRI and ultrasound give your doctor an image of your joint.
- Lab tests. Your doctor might use a needle to take a bit of fluid from your bursa and test it for signs of infection.
Bursitis usually gets better on its own after a few weeks of resting the affected area. Try not to put pressure on it, and avoid activities that make the pain worse.
You can take medicine such as ibuprofen or naproxen sodium to lower the swelling and help with pain. Your doctor might give you this medicine in cream or lotion form.
See your doctor if you don’t feel better after resting the affected area. Call your doctor right away if you can’t move the joint at all or the area around it is very swollen or red. If you have a fever or there’s a rash or bruise on the area, you should see a doctor—these are signs that your bursitis might be caused by an infection.
Your doctor will do an exam to make sure it’s bursitis and not something else. They might have you bend or move the affected joint, or ask you to move around or walk. This helps them figure out which bursa is inflamed, and suggest exercises to help you heal. They might also do blood tests or imaging, such as an ultrasound or MRI, to get more information.
If your doctor thinks an infection could be causing your bursitis, they might take some fluid out using a small needle, and then test the fluid for bacteria. Your doctor will give you antibiotics to take at home if you have an infection. It’s rare, but you might need to stay in the hospital and get antibiotics through an IV, especially if you have immune system problems or if the infection is very bad.
Your doctor might give you steroids, a medicine that works quickly to lower inflammation and pain. They might prescribe steroid pills to take at home or use a small needle to inject steroids or pain medicine into the irritated area. Doctors disagree about whether steroid shots are helpful.
Depending on where your bursitis is, your doctor might tell you to use a cane, crutches or a brace, elastic bandage, or split.
Physical therapy can help you strengthen muscles and increase your joint's range of motion. Your physical therapist might also teach you exercises for your core (the muscles in your back and belly that hold you up). A doctor or physical therapist can show you ways of sitting, standing, and moving that help bursitis get better or stop it from happening again.
It’s rare, but you might need surgery if other treatments aren’t helping.
Bursitis Home Remedies
Here are some things you can do to help your bursitis get better:
- Rest. Rest the area as much as you can, and avoid doing anything that makes the pain worse.
- Ice. Put an ice pack or cold compress on the area to help the swelling go down. After the first 2 days of icing it, you can also use a heating pad, hot water bottle, or heat pack, or take a hot bath or shower.
- Support the joint. Use a brace, ace bandage/elastic band, or splint to cushion the joint.
- Elevate it. Put the affected joint up on pillows.
- Cushioning. Pad the affected area and avoid hard surfaces. For example, use knee pads or a padded mat if you need to kneel down for work, or sit on a donut-shaped pillow or padded cushion instead of on the floor.
- Stretching and exercise. Stretch before exercising. Doing exercises that strengthen your core muscles and make you more flexible can help some kinds of bursitis.
- Posture. Use good posture and body mechanics. A doctor or physical therapist can help you learn ways to move, sit, and lift that are easy on your body and won’t irritate your joints.
- Massage. Massaging the area can help, but you should check with your doctor to make sure your bursitis isn’t caused by an infection before you massage it.
- Avoid repetitive movements, pressure, and heavy lifting. If possible, avoid putting pressure on the area, don’t lift heavy things, and try not to do the same motions over and over. If you can’t avoid this, take as many breaks as you can. Ask your doctor for a note if you need to miss work or make changes to the kind of work you do—for example, sitting on a padded chair instead of standing.
Bursitis is a painful swelling in one of the sacs of fluid that cushion your joints. It is caused by making the same motion over and over, leaning or putting pressure on your joints, or an injury or infection. The condition usually goes away on its own, but you should see your doctor if you have a fever, a lot of swelling or redness, a rash or bruising on the area, or if it hurts too much to move your joint.
What triggers bursitis?
Bursitis can be triggered by an injury or bump to one of your bursas. Sometimes, you don’t remember the injury because it didn’t hurt at the time.
Bursitis can also be caused by leaning on a joint for long periods and by making the same motions over and over. This often happens at work, for example, if you kneel on the ground to garden or fix cars, or make the same movements working on an assembly line or at a desk.
Exercises such as running or biking can put pressure on your joints and lead to bursitis.
It’s rare, but some kinds of surgeries can trigger bursitis.
Older adults and people who have arthritis, diabetes, gout, or other health problems are more likely to get bursitis. If you are older or you have problems with your immune system, you have a higher risk of getting the kind of bursitis that’s caused by an infection. Sometimes, doctors don’t know what causes bursitis.
Does bursitis go away on its own?
Bursitis often goes away by itself. Resting the area and using home remedies can help it get better. If your bursitis pain doesn’t get better after resting it and avoiding activities that make the pain worse, you should see your doctor.
If your bursitis is caused by an infection, it’s less likely to go away on its own, because you need antibiotics to treat it. You should see your doctor right away if you have a fever, or if the affected area is very warm, red, or has a rash or bruises on it.