Bursitis is inflammation of a bursa. The shoulder, elbow, hip and knee are the joints most commonly affected by bursitis. Bursitis may be mistaken for arthritis. Common causes of bursitis include injury and overuse. Treatment may include rest, painkillers and gentle exercises.
Bursitis is inflammation of a bursa. Bursae are small fluid-filled sacs located between two adjoining structures, usually muscles, tendons and bones.
Bursae reduce friction and assist movement of the tendon over the bony surface. Bursitis does not cause joint deformity, but can cause significant pain and restrict movement.
Bursae are located outside the joint itself. Since both tendons and bursae are located near joints, inflammation in these soft tissues may be mistaken for arthritis. However, arthritis involves inflammation within joints, whereas bursitis involves inflammation outside the joint.
Symptoms of bursitis
The symptoms of bursitis may include:
- Localised pain
- A warm feeling in or around the affected area
- Increased pain at night
- Pain worsened by movement
- Reddening of the skin.
The shoulder, elbow, hip, knee and heel are the most common sites of bursitis.
Causes of bursitis
Injury, repeated pressure and overuse are common causes of bursitis. Certain disorders (such as rheumatoid arthritis, gout and diabetes) can also contribute to its development.
A common cause of bursitis is overuse of a particular body part, especially if that activity is performed awkwardly or with considerable pressure.
Examples of work-related activities that may trigger bursitis include production-line packing and typing. Sports that can cause bursitis include jogging, tennis and squash.
Overuse injuries other than bursitis include:
- Carpal tunnel syndrome – a painful disorder of the hand leading to increased pressure on the main nerve that runs through the wrist
- Ganglion – a cyst on a tendon or joint capsule
- Tennis elbow – inflammation of tendons surrounding the elbow joint
- Tenosynovitis – inflammation of the tendons (the tough connective tissue that anchors muscle to bone).
Diagnosis of bursitis
Bursitis is generally detected as a tender, warm swelling at the site of a bursa. A diagnosis may include investigating and ruling out any other possible causes.
Tests performed to confirm or rule out bursitis may include:
- Physical examination
- Medical history
- X-rays, to rule out the possibility of any other condition
- Drawing off fluid from the bursa to rule out the possibility of infection.
Treatment for bursitis
Treatment will depend on the cause of the bursitis. Treatment aims to alleviate the symptoms as much as possible while the healing process takes place.
Treatment options may include pain-relieving medications, cold packs, gentle mobilising exercises and rest. Anti-inflammatory medications or injections of corticosteroids may be used in cases of severe pain.
If infection is present, warmth, redness, pain and swelling will be experienced in the affected areas. Treatment with an appropriate antibiotic is necessary. If the bursitis was triggered by a particular form of overuse, it is important to avoid that activity.
Correct posture and joint protection are useful, and braces or splints can decrease the stress on the areas and support good alignment. After an acute attack, it is important to consider how recurrences can be prevented.
Long-term management of bursitis
Your doctor or physiotherapist can offer suggestions and strategies to reduce your risk of developing bursitis again.
To prevent recurrence of work-related bursitis:
- Use ergonomically-designed furniture and equipment.
- Take regular breaks.
- Do simple stretching exercises for 10 minutes every hour.
- Keep benches at waist height so that the shoulders can relax.
To prevent recurrence of sport-related bursitis:
- Warm up thoroughly by stretching and gently going through the motions of your chosen sport.
- Make sure you use good form and regularly practice strengthening and conditioning exercises that complement your particular sport.
- Cool down thoroughly with gentle, sustained stretches.
- Make sure footwear and equipment are appropriate for you.
Where to get help
- Your doctor
- Arthritis Victoria Tel. (03) 8531 8000 or 1800 011 041 (toll free)
- Australian Physiotherapy Association Tel. 1300 306 622
Things to remember
- Bursitis is inflammation of a bursa.
- Bursae are small sacs that contain fluid to lubricate moving parts, such as joints, muscles and tendons.
- Common causes of bursitis include injury and overuse.
- Treatment includes rest, ice packs, gentle mobilisation exercises and avoiding the activity that prompted the condition.
You might also be interested in:
- Carpal tunnel syndrome.
- Knee injuries.
- Neck and shoulder pain.
- Rheumatoid arthritis.
- Workplace safety - overuse injuries.
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Last reviewed: April 2013
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