Patient education: Bursitis (The Basics)

What is bursitis? — 

This is a condition that can cause pain or swelling next to a joint. It usually happens around the elbow, knee, or ankle. It can also happen around other joints in the body.

A "bursa" is a small fluid-filled sac that sits near a bone. It cushions and protects nearby tissues when they rub on or slide over bones. These sacs, called "bursae," are found in many places throughout the body (figure 1 and figure 2 and figure 3 and figure 4). Bursitis happens when a bursa gets irritated and swollen. This can happen when a person:

●Moves a joint over and over again in the same way, over a short period of time

●Rests part of their body on a hard surface, or stays in a position that presses on the bursa for a long time

●Has certain kinds of arthritis, such as gout or rheumatoid arthritis, that can affect their joints and bursae

●Gets hurt near a bursa

●Has an infection that spreads to a bursa

What are the symptoms of bursitis? — 

Symptoms can include:

●Pain or tenderness

●Swelling

●The skin over the bursa feeling warm or changing color (for example, looking redder or darker than usual)

●Trouble moving the joint

If a bursa gets infected with bacteria, it can also cause a fever. If you have any symptoms of an infected bursa, tell your doctor or nurse as soon as possible.

Will I need tests? — 

Maybe. Your doctor or nurse will ask about your symptoms and do an exam.

Your doctor might do tests to help figure out if you have bursitis or another problem. Tests can include:

●Using a needle to remove some fluid from the bursa. Then, they can do lab tests on the fluid to find out what is causing the bursitis and see if you need antibiotics. Your doctor might do this if you have symptoms of:

•An infected bursa

•Gout

•Rheumatoid arthritis

●Ordering imaging tests, such as an MRI scan or ultrasound. These create pictures of the inside of the body. Your doctor might order these to:

•Help guide the needle while removing fluid from the bursa

•Check for other problems in or near the bursa

Your doctor might do blood tests to help figure out what is causing your bursitis.

How do I treat my bursitis at home? — 

You should:

●Rest, cushion, and protect the area – Try not to irritate the area that hurts. For example, if you have bursitis in:

•Your shoulder – You might need to avoid lifting or carrying heavy things for a while.

•Your elbow – You might need a special brace to protect your elbow. These are usually a hard shell with soft padding on the inside. You can also use elbow pads.

•Your knee – You might need a special brace to protect your knee. In some cases, you might need a brace that keeps your knee from bending. You can also use knee pads or a kneeling pad.

•Your hip – You can use pillows for extra cushioning when you sit. Sitting on a special pillow shaped like a donut might help. If you spend most of the day sitting, try taking small breaks to stand and walk.

•The back of your heel – You might need to use a thick heel pad. This can raise your heel so it does not rub against the back of your shoe.

If you cannot avoid movements that cause pain, try to take breaks often.

●Avoid positions that put pressure on the area – For example, if you have bursitis in:

•The front of your knee – Avoid kneeling.

•The outside of your elbow – Avoid propping your elbows on tables or desks.

•Your shoulder, elbow, or hip – Avoid sleeping on the side that hurts.

•Your hip, knee, or ankle – Try placing a pillow between your legs when sleeping on your side.

●Put ice on the area to reduce pain – Use a cold gel pack, bag of ice, or bag of frozen vegetable a few times a day for 20 minutes each time.

What other treatments might I have? — 

Your doctor or nurse might use other treatments, depending on:

●Your symptoms

●Where your bursitis is

●What caused your bursitis

Treatments can include:

●Pain-relieving medicines called "NSAIDs" – These include ibuprofen (sample brand names: Advil, Motrin) and naproxen (sample brand name: Aleve). These can reduce pain and prevent the bursae from getting swollen and painful.

●Steroid injections – Steroid medicines help reduce inflammation. Doctors can inject steroids into the area of the bursitis to help reduce symptoms.

●Exercises and stretches – Your doctor or nurse might recommend you work with a physical therapist. A physical therapist can teach you stretches and exercises to help reduce your symptoms.

●Surgery – Your doctor might recommend surgery if other treatments do not work and you have had symptoms for a long time.

People with an infected bursa might also have treatment that includes:

●Antibiotics

●Having the fluid in the bursa drained – A doctor can drain the fluid using a needle and syringe, or by doing surgery.

If your bursitis was caused by another condition, your doctor will also treat that condition.

How can I prevent getting bursitis? — 

To help lower your chances of getting bursitis, you can:

●Use cushions or pads to avoid putting too much pressure on joints – For example, people who garden can kneel on a kneeling pad. People who sit for a long time can sit on a cushioned chair.

●Take breaks, if you are using a certain joint too much.

●Stop an activity or change the way you are doing it, if you feel pain.

●Exercise.

●Lose weight, if you have excess body weight.

●Use good posture.

When should I call the doctor? — 

Call your doctor or nurse for advice if:

●You have a fever of 100.4°F (38°C) or higher, or chills.

●Your symptoms do not get better or start to get worse.

More on this topic

Patient education: Hip pain in adults (The Basics)
Patient education: Osteoarthritis (The Basics)
Patient education: Gout (The Basics)
Patient education: Rheumatoid arthritis (The Basics)
Patient education: Weight loss treatments (The Basics)
Patient education: Knee pain (The Basics)
Patient education: Knee arthroscopy (The Basics)

Patient education: Bursitis (Beyond the Basics)
Patient education: Osteoarthritis symptoms and diagnosis (Beyond the Basics)
Patient education: Osteoarthritis treatment (Beyond the Basics)
Patient education: Gout (Beyond the Basics)
Patient education: Rheumatoid arthritis symptoms and diagnosis (Beyond the Basics)
Patient education: Rheumatoid arthritis treatment (Beyond the Basics)
Patient education: Knee pain (Beyond the Basics)