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Overview

What Is Bursitis?

Bursae are small, fluid-filled sacs that cushion moving tissues and help bones, tendons, muscles, and skin glide smoothly around a joint. When a bursa becomes irritated and inflamed, it can cause localized pain, tenderness, and swelling; this condition is called bursitis. It may affect the hip, shoulder, knee, elbow, heel, or other pressure points. Repetitive use, prolonged pressure, an injury, or an infection can all cause bursitis.

Symptoms

Bursitis Symptoms

  • Localized pain develops over or around the affected bursa.
  • The area may be tender when touched.
  • Swelling may appear over the affected joint or pressure point.
  • The skin may feel warm or look red (erythema).
  • Stiffness or reduced movement may affect the nearby joint.
  • Pain may worsen with pressure or movement.
  • Hip bursitis symptoms may include pain on the outside of the hip, especially when lying on that side or walking.
  • Shoulder bursitis may cause pain when lifting or reaching with the arm.
  • Knee, elbow, or heel bursitis may cause swelling and discomfort where repeated pressure occurs.

Possible infection

Know the warning signs

Fever, marked warmth or redness, drainage, or rapidly worsening pain may indicate infected bursitis. Seek prompt medical assessment if these symptoms occur.

Causes

What Causes Bursitis?

Irritation, repeated friction, or trauma can cause a bursa to become inflamed, leading to pain and swelling. Most cases are noninfectious, but septic bursitis occurs when bacteria infect the bursa. Gout, rheumatoid arthritis, and other inflammatory disorders can also trigger inflammation in a bursa, including bursitis in the hip or inflammation near the shoulder.

Cause patternHow it can lead to bursitis
Repetitive movement or overuseRepeated motion, such as throwing or climbing stairs, can irritate a bursa over time.
Prolonged pressureKneeling, leaning on an elbow, or sitting for long periods can compress a bursa, such as the ischial bursa.
Direct blow or fallA hit or fall can injure the bursa and cause sudden inflammation and swelling.
Inflammatory diseaseGout, rheumatoid arthritis, and similar conditions can inflame bursae, including subacromial or subacromial subdeltoid bursae.
InfectionBacteria entering a break in the skin or nearby tissue can cause septic bursitis.

Risk Factors

Bursitis Risk Factors

MODIFIABLE FACTORS

Risk can increase with repetitive sports or work, kneeling, leaning on the elbows, prolonged sitting, poor technique, or sudden increases in training. Other potentially addressable factors include inadequate equipment, excess pressure on the foot, and health conditions such as diabetes or weakened immunity; these may contribute to problems sometimes described as foot bursitis or TR bursitis.

LESS-MODIFIABLE FACTORS

Risk is also higher with older age, previous bursitis, inflammatory arthritis, gout, or other underlying medical conditions. These factors may make recurrence more likely even when activity and pressure are carefully managed.

Complications

Bursitis Complications

Persistent or recurrent inflammation can limit movement and interfere with work, exercise, sleep, and daily activities. Infected bursitis can spread into nearby tissues or, rarely, into the bloodstream if it is not treated. Repeated episodes may require additional evaluation for gout, rheumatoid arthritis, or another inflammatory condition.

Diagnosis

How Bursitis Is Diagnosed

Diagnosis usually begins with a discussion of symptoms, activities, injuries, and medical conditions, followed by a physical examination. A clinician checks for tenderness, swelling, range of motion, activity-related triggers, and signs of infection. The evaluation also helps distinguish bursitis of the shoulder or another joint from problems affecting the bones, tendons, or joint itself.

  • Ultrasound or an X-ray may be used when the bursa’s location is uncertain or another joint problem needs to be considered.
  • An MRI may be recommended in selected cases when deeper or more complex tissue problems are suspected.
  • Blood tests may help when inflammatory disease or infection is suspected.
  • Aspiration of bursal fluid may be performed when infection or crystals from gout need to be tested.

Treatment & Management

Bursitis Treatment and Management

Clinical treatment options

  • Physical therapy can improve movement, strength, technique, and load management for problems such as hip or shoulder bursitis.
  • A corticosteroid injection may be considered in selected noninfectious cases when symptoms persist.
  • Aspiration may remove excess fluid and allow testing when infection or crystals are suspected.
  • Antibiotics are used to treat infected bursitis when bacteria are the cause.
  • Surgery is rarely needed, but may be considered for persistent or recurrent bursitis that does not respond to other treatment.

Prevention

How to Prevent Bursitis

  • Use knee or elbow padding during tasks that involve repeated pressure on those areas.
  • Change position regularly instead of kneeling, leaning, or sitting in one position for long periods.
  • Warm up before activity and increase exercise gradually rather than making sudden training changes.
  • Use proper technique and well-fitted equipment during work, sports, and exercise.
  • Strengthen and stretch the affected area as advised by a clinician or physical therapist.
  • Maintain a healthy weight when relevant to reduce load on the hips, knees, and feet.
  • Work with a clinician to manage gout, arthritis, diabetes, or other conditions that may contribute to inflammation.

Outlook and Prognosis

Bursitis Outlook and Prognosis

Many noninfectious cases improve with pressure reduction, activity modification, and appropriate treatment, although recovery varies by the bursa involved and the underlying cause. Recurrence is more likely when the provoking activity continues or an inflammatory condition remains untreated. Infected bursitis requires timely treatment because it can worsen or spread.

When Should You See a Doctor

When Should You See a Doctor for Bursitis?

Arrange medical care

Know when to get checked

Seek medical assessment for severe or worsening pain, inability to move the joint, symptoms that do not improve with self-care, or repeated episodes. It is also sensible to be checked if you are unsure whether the symptoms are bursitis or another joint problem.

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