Bursitis

Student's elbow; Olecranon bursitis; Housemaid's knee; Prepatellar bursitis; Weaver's bottom; Ischial gluteal bursitis; Baker's cyst; Gastrocnemius - semimembranosus bursa

Bursitis is the swelling and irritation of a bursa. A bursa is a fluid-filled sac that acts as a cushion between muscles, tendons, and bones.

Causes

Bursitis is often a result of overuse. It can also be caused by a change in activity level, such as training for a marathon, or by being overweight.

Other causes include trauma, rheumatoid arthritis, gout, or infection. Sometimes, the cause can't be found.

Bursitis commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the area around the Achilles tendon and the foot.

Symptoms

Symptoms of bursitis may include any of the following:

Joint pain and tenderness when you press around the joint
Joint pain
Joint pain can affect one or more joints.
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Stiffness and aching when you move the affected joint
Swelling, warmth or redness over the joint
Swelling
Swelling is the enlargement of organs, skin, or other body parts. It is caused by a buildup of fluid in the tissues. The extra fluid can lead to a ...
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Pain during movement and rest
Pain may spread to the nearby areas

Exams and Tests

The health care provider will ask about your medical history and perform a physical exam.

Tests that may be ordered include:

Laboratory tests to check for infection
Removing fluid from the bursa
Removing fluid from the bursa
Synovial fluid analysis is a group of tests that examine joint (synovial) fluid. The tests help diagnose and treat joint-related problems.
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Analysis including culture of the fluid
Culture of the fluid
Joint fluid culture is a laboratory test to detect infection-causing germs in a sample of fluid surrounding a joint.
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Ultrasound
MRI

Treatment

Your provider will talk to you about a treatment plan to help you resume your normal activities, including some of the following tips.

Tips to relieve bursitis pain:

Use ice 3 to 4 times a day for the first 2 or 3 days.
Cover the painful area with a towel, and place the ice on it for 15 minutes. Do not fall asleep while applying the ice. You can get frostbite if you leave it on too long.
Rest the joint.
When sleeping, do not lie on the side that has bursitis.

For bursitis around the hips, knees, or ankle:

Try not to stand for long periods.
Stand on a soft, cushioned surface, with equal weight on each leg.
Placing a pillow between your knees when lying on your side can help decrease pain.
Flat shoes that are cushioned and comfortable often help.
If you are overweight, losing weight may also be helpful.

You should avoid activities that involve repetitive movements of any body part when possible.

Other treatments include:

Medicines such as NSAIDs (ibuprofen, naproxen)
Physical therapy
Wearing a brace or splint to support the joint and help reduce inflammation
Exercises you do at home to build strength and keep the joint mobile as pain goes away
Removing fluid from the bursa and getting a corticosteroid shot

As the pain goes away, your provider may suggest exercises to build strength and keep movement in the painful area.

In rare cases, surgery is done.

Outlook (Prognosis)

Some people do well with treatment. When the cause cannot be corrected, you may have long-term pain.

Possible Complications

If the bursa is infected, it becomes more inflamed and painful. This often requires antibiotics or surgery.

When to Contact a Medical Professional

Contact your provider if symptoms recur or do not improve after 3 to 4 weeks of treatment, or if the pain is getting worse.

Prevention

When possible, avoid activities that include repetitive movements of any body parts. Be aware of your posture when doing the activities. Strengthening your muscles and working on your balance may help decrease the risk of bursitis.

Open References

References

Biundo JJ. Bursitis, tendinitis, and other periarticular disorders and sports medicine. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 247.

Hogrefe C, Jones EM. Tendinopathy and bursitis. In: Walls RM, Hockberger RS, Gausche-Hill M, Erickson TB, Wilcox SR, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 103.

Bursa of the elbow - illustration
Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints, such as the elbow. The function of a bursa is to facilitate movement and reduce friction between moving parts.
Bursa of the elbow
illustration
Bursa of the knee - illustration
Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints, such as the knee. The function of a bursa is to facilitate movement and reduce friction between moving parts.
Bursa of the knee
illustration
Bursitis of the shoulder - illustration
Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints. Their function is to facilitate movement and reduce friction between moving parts. When a bursa becomes infected, traumatized, or injured it is referred to as bursitis.
Bursitis of the shoulder
illustration

Bursa of the elbow - illustration
Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints, such as the elbow. The function of a bursa is to facilitate movement and reduce friction between moving parts.
Bursa of the elbow
illustration
Bursa of the knee - illustration
Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints, such as the knee. The function of a bursa is to facilitate movement and reduce friction between moving parts.
Bursa of the knee
illustration
Bursitis of the shoulder - illustration
Bursae are fluid-filled cavities located at tissue sites where tendons or muscles pass over bony prominences near joints. Their function is to facilitate movement and reduce friction between moving parts. When a bursa becomes infected, traumatized, or injured it is referred to as bursitis.
Bursitis of the shoulder
illustration

Self Care

Tests for Bursitis

Review Date: 9/20/2022

Reviewed By: C. Benjamin Ma, MD, Professor, Chief, Sports Medicine and Shoulder Service, UCSF Department of Orthopaedic Surgery, San Francisco, CA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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Health Library

Bursitis

Causes

Overweight

Rheumatoid arthritis

Gout

Symptoms

Joint pain

Swelling

Exams and Tests

Removing fluid from the bursa

Culture of the fluid

Treatment

Outlook (Prognosis)

Possible Complications

When to Contact a Medical Professional