Bursitis

A healthy bursa is a thin jelly-like sac that forms a cushion in your joints where bones meet soft tissue – the muscles, tendons, or ligaments. Bursae minimise rubbing between these surfaces, making movement easier.

You have around 160 bursae in your body and any one of them can become inflamed. The joints that are most often affected are:

• Elbow (olecranon bursitis)
• Foot pain
• Shoulder pain
• Hip joints (trochanteric bursitis)
• Knee (housemaid’s knee or prepatellar bursitis)
• Shoulder (impingement)

Bursitis happens when these cushions become enlarged (inflamed) for some reason. Rotator cuff injury can lead to bursitis.

The most common bursitis symptoms (or warning signs) are:

• Pain
• Swollen joints
• Tenderness - even when the joint isn’t moving
• Your joint may feel warm

If the swelling doesn’t go away, your joint may become stiff – this can lead to muscle wastage.

See your doctor if your bursitis symptoms get worse or don’t improve after a couple of weeks.

Make an appointment if you:

• Can’t move the affected joint
• Have a high temperature or feel shivery
• Have sharp shooting pains in the joint

It's important to get an accurate diagnosis for bursitis as symptoms may be a sign of rheumatoid arthritis or gout instead. Tests for bursitis include:

• A fluid sample from the swelling to check for infection or signs of any blood from an injury
• An ultrasound scan or MRI scan to check for any muscle damage
• Blood tests
• X-ray to see if you’ve broken a bone

Causes may include:

• Crystal-induced disease, such as gout
• Earlier hip surgery leading to trochanteric (hip) bursitis
• Infection
• Injury causing bleeding into the bursa
• Overuse or repetitive exercises

However, in many cases, the cause of bursitis is unknown (idiopathic).

You can’t always prevent bursitis, but you can reduce the risk of a flare-up by:

• Keeping to a healthy weight
• Lifting heavy weights correctly by bending your knees
• Strengthening muscles

Bursitis treatments include some simple things you can do yourself:

• Rest – don’t move or exercise your joint too much
• Ice – use an ice pack (or similar) wrapped in a tea towel. Put this on the swelling for about 10 minutes and repeat regularly every few hours
• Elevate – keep the swelling level with your heart if possible
• Medication – with over-the-counter anti-inflammatory medication, if advised by your GP (eg ibuprofen)

If the swelling doesn’t go away within a couple of weeks, arrange to see your GP.

Your GP may advise treatment with:

• Antibiotics – when the cause is an infection
• Further rest – when the possibility of infection has been ruled out
• High-dose non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen

Further treatment

Bursitis treatment doesn’t usually include surgery.

In some cases a steroid injection may be given by your GP or at hospital. A steroid injection won’t cure the bursitis but should reduce inflammation and pain for a couple of months. Steroids can have side-effects so your doctor will discuss these with you and decide whether it's right for you.