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Bursitis is a common but misunderstood condition that can significantly impact daily life. It is characterised by pain and swelling in areas where tendons, muscles, and skin rub over bones. Bursitis is an inflammation of the bursa, a small, fluid-filled sac that cushions and lubricates joints. While it may not always be serious, the discomfort it causes can be persistent and sometimes debilitating if left unaddressed.
In this article, we will explore bursitis, its causes, symptoms, and the most effective treatment options available, empowering you with the knowledge to recognise and manage this condition.
What Is Bursitis?
Bursae (plural of bursa) are tiny sacs throughout the body, especially near major joints like the shoulders, elbows, hips, and knees. These sacs cushion between bones and soft tissues, reducing friction and facilitating smooth movement. When a bursa becomes irritated or inflamed, it leads to bursitis, a condition that can cause pain, restricted movement, and tenderness around the affected joint.
In India, specific data on the overall incidence of bursitis is limited. However, a study focusing on chronic shoulder pain among adult patients found that 4.1% had subacromial bursitis. This suggests that while bursitis is a recognized condition, its prevalence may vary based on the population and the specific joint involved.
Although bursitis can occur in any bursa, the most common types include:
- Shoulder bursitis
- Hip bursitis
- Elbow bursitis (olecranon bursitis)
- Knee bursitis (prepatellar bursitis)
- Heel bursitis (retrocalcaneal bursitis)
What Causes Bursitis?
There are several reasons why a bursa might become inflamed. The condition is often linked to repetitive movement or pressure on a particular area but can also result from injury, infection, or underlying health conditions.
1. Repetitive Motion or Overuse
One of the most common causes of bursitis is repetitive movement or prolonged pressure on a joint. Occupations or hobbies that involve kneeling, leaning on elbows, or repetitive lifting are known triggers. Athletes, gardeners, carpenters, and musicians are most commonly affected.
2. Acute Injury
A direct blow or fall can cause sudden inflammation of a bursa. This is especially common in joints like the knee or elbow, where trauma is more likely to occur during physical activity.
3. Ageing and Degeneration
As we age, our tendons and bursae naturally become less elastic and more prone to inflammation. Middle-aged and older adults are more likely to develop bursitis simply due to the wear and tear of everyday life.
4. Inflammatory Conditions
Chronic illnesses such as rheumatoid arthritis, gout, and psoriatic arthritis can also lead to bursitis. These autoimmune conditions cause systemic inflammation, which may affect multiple bursae.
5. Infection (Septic Bursitis)
Sometimes, the bursa can become infected by bacteria, especially in the elbow or knee. This form of bursitis is known as septic bursitis and requires prompt medical attention.
Recognising the Symptoms
The hallmark symptoms of bursitis typically involve localised discomfort around a joint. Depending on the severity and cause, you may experience:
- Pain: A dull, aching pain at the site of inflammation, often worsened by movement or pressure.
- Swelling: Noticeable puffiness around the joint, particularly in the elbow, knee, or hip.
- Tenderness: The affected area may feel sore to the touch.
- Restricted Movement: You may struggle with moving the joint freely without pain or stiffness.
- Warmth or Redness: In cases of septic bursitis, the skin over the joint may appear red and feel warm.
It is worth noting that symptoms might develop gradually, primarily if caused by repetitive activity, or suddenly following trauma or infection.
Diagnosing Bursitis
If you suspect you have bursitis, it’s essential to seek medical advice to ensure accurate diagnosis and treatment. Your healthcare provider may:
- Conduct a physical examination to assess tenderness and range of motion.
- Recommend imaging tests such as X-rays, ultrasound, or MRI to rule out other conditions like arthritis or tendon tears.
- If infection is suspected, order fluid aspiration (removing fluid from the bursa with a needle). The sample can be analysed for bacteria or crystals, especially in gout or septic bursitis cases.
Early diagnosis is vital to prevent complications and prolonged discomfort.
Treatment Options
Most cases of bursitis can be managed with conservative, non-invasive methods. However, treatment strategies may vary depending on the underlying cause, severity, and whether an infection is present.
1. Rest and Activity Modification
The first line of defence is often to rest the affected joint and avoid activities that exacerbate the symptoms. Temporary cessation of repetitive motions gives the bursa time to heal.
2. Ice and Compression
Applying ice packs several times daily can help reduce swelling and numb pain. Compression wraps may also be used, particularly for joints like the knee or elbow.
3. Medications
Over-the-counter anti-inflammatory drugs such as ibuprofen or naproxen can relieve pain and inflammation. In some cases, more potent prescription medications may be necessary.
4. Physical Therapy
Once acute pain subsides, physical therapy can strengthen surrounding muscles, improve joint function, and prevent future flare-ups. Stretching and range-of-motion exercises are particularly beneficial.
5. Corticosteroid Injections
If conservative methods fail, your doctor may recommend a corticosteroid injection directly into the affected bursa. This can provide rapid relief from pain and swelling, but repeated use should be avoided due to potential side effects.
6. Antibiotics (For Septic Bursitis)
In cases of infection, oral or intravenous antibiotics are necessary. Hospitalisation might be required if the infection is severe. Sometimes, the infected bursa may need to be drained surgically.
7. Surgery (Rare)
Surgical bursa removal (bursectomy) is rare and typically reserved for chronic, non-responsive cases. Most people recover well with non-surgical treatments.
Preventing Bursitis
While not all cases of bursitis can be avoided, especially those linked to age or underlying illness, there are several preventive steps you can take:
- Use protective gear: Knee pads or elbow cushions can help reduce joint pressure during repetitive activities.
- Take regular breaks: Avoid prolonged periods of stress on a single joint. Stretch frequently and alternate tasks when possible.
- Maintain a healthy weight: Excess body weight increases joint stress, particularly in the hips and knees.
- Warm-up and cool-down: Proper warm-up and cool-down routines can prevent strain and overuse if you exercise regularly.
- Practice good posture: Ergonomic workspaces and mindful movement reduce unnecessary pressure on joints.
Living with Bursitis
For many, bursitis is a temporary condition that resolves with self-care and medical treatment. However, those with chronic bursitis or autoimmune conditions may experience recurrent episodes. Ongoing management strategies—such as physiotherapy and lifestyle adjustments—are essential in such cases.
Awareness and early intervention are key. The sooner bursitis is addressed, the quicker the recovery and the lower the risk of long-term joint problems.
When to See a Doctor
You should consult a healthcare professional if:
- The pain is severe or persistent.
- You notice redness, warmth, or significant swelling.
- You develop a fever and joint pain (a potential sign of infection).
- The condition doesn’t improve after a week of rest and home care.
Final Thoughts
Bursitis may be common, but it is highly manageable with the right knowledge and care. Whether you're a sportsperson, desk worker, or someone dealing with the effects of ageing, understanding how inflammation of the bursa occurs—and how to treat it—can make a substantial difference in your quality of life.
Simple lifestyle changes, timely treatment, and informed choices are your best allies in keeping joints healthy and pain-free.
References
- Johns Hopkins Medicine. Bursitis
- Cleveland Clinic. Bursitis: Symptoms, Causes & Treatment
- Mayo Clinic. Bursitis – Symptoms and Causes
- WebMD. Bursitis Guide
- Max Healthcare. Bursitis: Symptoms, Types, and Diagnosis
- Penn Medicine. Bursitis Information
