Bursitis: Symptoms, Causes, Treatment & Prevention
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Introduction
Bursitis symptoms causes treatment and prevention means “care basics”: signs, triggers, safeguards.
Bursitis is swelling in a small, fluid-filled sac near a joint 1,6. These sacs protect nearby bones, muscles, tendons, ligaments, and skin from friction 1,5.
Repeated movement and pressure are common triggers 1,6. Injury, arthritis, gout, and infection can also cause this problem 1,7.
Most cases improve with rest and home care 6. However, infected bursitis needs medical care and antibiotics 5,6.
This guide explains common symptoms, causes, tests, and treatment. It also covers infection warning signs and ways to prevent flare-ups.
Overview: What Is Bursitis?
How bursae cushion moving tissues
A bursa is a thin sac that contains joint-like fluid 1,5. The human body contains more than 150 bursae 1,5.
These sacs reduce friction between bones and nearby moving tissues 1,5. Those tissues include muscles, tendons, ligaments, and skin 1,5.
Some bursae sit between the skin and deeper tissues 10. Others protect tendons as they move across nearby bones 10.
Irritation makes a bursa swell with extra fluid 1,5. Movement or pressure may then squeeze the swollen sac against other tissues 1. This pressure can cause pain 1.
Acute, chronic, and recurrent bursitis
Acute bursitis develops over a short period. It often follows trauma, infection, or crystal-related joint disease 1.
If acute bursitis occurs, pressing the swollen area may hurt 1. Active movement may also cause pain 1. Nearby muscles can squeeze the sore bursa during movement 1.
Chronic bursitis often follows overuse or lasting pressure 1. Inflammatory arthritis can also play a role 1.
If chronic bursitis occurs, the sac may thicken and swell 1. Some chronic cases cause marked swelling with little pain 1.
Recurrent bursitis causes repeated flare-ups in the same area 6. Repeated pressure or movement can lead to these ongoing episodes 3,6.
Common locations
Bursitis may affect many parts of the body 6. Common sites include:
Shoulder bursitis affects a sac beneath part of the shoulder blade 3.
Elbow bursitis affects the sac over the elbow point 9.
Knee bursitis often affects a sac near the kneecap 5,6.
Hip bursitis affects a sac near the outer thigh bone 8.
Foot bursitis may occur near the heel or big toe 6.
Outer hip pain does not always come from bursitis alone 2. Doctors often call this problem greater trochanteric pain syndrome, or GTPS 2.
GTPS may include bursitis, tendon damage, and snapping hip 2. Several of these problems can occur together 2.
Symptoms and Warning Signs
Common bursitis symptoms
If bursitis occurs, common signs include pain, swelling, and limited movement 6. The area may also feel tender, achy, or stiff 1,7.
Symptoms may follow these patterns:
If the affected area moves, pain may become worse 6,7.
If pressure reaches the bursa, the area may hurt more 1,7.
If pain limits movement, the nearby joint may feel stiff 1,7.
If the problem becomes chronic, large swelling may cause little pain 1.
If the bursa lies near skin, swelling may be easy to see 9,10.
Pain and swelling do not prove that bursitis is present. Tendon damage and joint problems can cause similar symptoms 2,3,9.
How symptoms vary by body area
The painful area can change how symptoms feel. Common patterns include:
If shoulder bursitis occurs, overhead movement may cause pain 3.
If elbow bursitis occurs, swelling may cover the elbow point 9.
If hip bursitis occurs, the outer hip may hurt 8.
If hip bursitis occurs, pain may reach the upper thigh 8.
If hip bursitis occurs, lying on that side may hurt 8.
If hip bursitis occurs, climbing stairs may worsen pain 8.
If infected elbow bursitis occurs, the skin may feel warm 9.
If infected elbow bursitis occurs, skin color may change 9.
Shoulder bursitis may occur with tendon irritation or a tendon tear 3. Read our [tendinitis guide](/conditions/tendinitis-symptoms-causes-treatment-prevention-dc94bb) for more about tendon problems.
Signs of septic bursitis
Septic bursitis means that infection has reached a bursa 5. It can resemble swelling that is not caused by infection 5.
Seek prompt medical care if any signs below occur:
If the swelling feels warm, contact a healthcare professional promptly 5,6.
If the skin looks red or discolored, seek prompt medical care 5,6.
If fever or chills occur, contact a healthcare professional promptly 6,7.
If a wound covers the swelling, seek prompt medical care 5.
If swelling becomes severe, arrange a medical assessment 7.
If pain limits daily tasks, contact a healthcare professional 7.
Redness may be harder to see on Black or brown skin 7. Look for changes from the person’s usual skin color.
Fever does not occur with every infected bursa 5. Its absence cannot reliably rule out infection 5.
Causes and Risk Factors
Repeated movement and lasting pressure
Repeated movement and prolonged pressure are common causes 1,6. They place ongoing stress on a bursa near a joint 1.
Activities linked with this condition include:
Frequent kneeling can irritate bursae near the knee 4,7.
Leaning on elbows can place lasting pressure on elbow bursae 1,7.
Repeated overhead lifting can irritate a shoulder bursa 3,7.
Throwing can place repeated stress around the shoulder 3,6.
Painting, raking, scrubbing, and shoveling may add repeated stress 6,7.
Running and cycling may place repeated stress around the hip 8.
Frequent stair climbing can irritate bursae near the hip 2,8.
Playing an instrument can repeatedly stress certain areas 6,9.
Poor posture may increase pressure on a bursa 6,8. Uneven leg length can also add stress around the hip 8. An altered walking pattern may strain tissues near the outer hip 2.
Injury and infection
A fall or direct blow can irritate a bursa 1,8. The injury may seem minor when it happens 1.
A puncture can carry bacteria through the skin 1,5. The bacteria may then enter a bursa near the skin 1,5.
Infection can also spread from nearby cellulitis 5. Cellulitis is an infection of the skin and deeper tissues 9.
Infected bursitis commonly affects bursae close to the skin 10. These bursae face a higher chance of cuts and direct injury 10.
About 80% to 90% involve *S. aureus* bacteria 5. This figure applies to acute infected bursitis 5. Streptococcus species are the next leading bacterial cause 5.
Arthritis and other health factors
Osteoarthritis and rheumatoid arthritis can raise the risk 1,7. Gout and other inflammatory joint diseases can also raise it 1,7.
Gout involves uric acid crystals that collect in joints 9. Learn more in our [gout guide](/conditions/gout-symptoms-causes-treatment-and-prevention-3acffd).
Jobs and hobbies can raise risk through repeated stress 6,7. Athletes, manual workers, factory workers, and musicians often face these movements 3,6.
Bursitis becomes more common with age 7. Older adults may have more wear within the shoulder area 3.
Diabetes and immune suppression raise the risk of infected bursitis 1. Inflammatory arthritis and gout may also raise this risk 5.
Extra body weight adds stress around the hips and knees 7. This added stress can increase the risk in those areas 7.
Diagnosis and Treatment
Physical examination
Diagnosis often begins with a review of symptoms and daily activities 2,6. A clinician may ask about work, sports, hobbies, or recent injuries 2,6.
The examination checks the painful or swollen area. The clinician looks for tenderness, warmth, swelling, and skin changes 1,5.
The clinician also checks how well the nearby joint moves 5. Movement testing can help separate bursitis from other problems 1,5.
However, an examination cannot always identify an infected bursa 5. Infected and noninfected swelling can look very similar 5.
Imaging tests
Simple shoulder bursitis may not need imaging 3. A clinician may order imaging to check for other causes 3,6.
X-rays can help rule out fractures and other bone problems 3,6.
X-rays may also show arthritis or shoulder shape changes 3.
Ultrasound can show a swollen bursa 6,9.
MRI can show a swollen bursa or damaged tendon 2,6.
Blood tests may check for possible infection 6,9.
A normal X-ray does not show most bursae 3. These sacs are soft tissues rather than bones 3.
Fluid testing for possible infection
Bursal aspiration uses a needle to remove fluid from the sac 5,6. The lab must test this fluid when infection is suspected 5.
A fluid sample is needed to confirm suspected infection 5. Symptoms and examination findings cannot make that distinction reliably 5.
A clinician may also check blood for signs of infection 6,9. Blood tests alone may not separate infected and noninfected bursitis 5.
Home care for uncomplicated bursitis
Rest is often enough to help uncomplicated cases improve 6. Avoid the movement or position that caused the irritation 6.
Common home care options include:
Rest the affected area and limit direct pressure 4,6.
Place wrapped ice on the area for 15 minutes 6.
Repeat cold treatment several times during the day 6.
Raise the swollen area when that is practical 6.
Use a brace, splint, or sling if advised 6.
Avoid activities that keep stressing the painful area 6.
Do not place ice directly against bare skin. Source guidance advises wrapping the ice in a thin towel 6.
A clinician may suggest acetaminophen, ibuprofen, or naproxen 6. These medicines may help with pain 6.
Do not use these pain medicines beyond 10 days without medical advice 6. Ask a clinician which medicine fits your health needs.
Physical and occupational therapy
Physical therapy can help improve movement 6. It can also strengthen muscles around an injured hip 8.
A therapist may provide stretches and exercises for hip pain 2,8. Shoulder care may also address nearby tendon problems 3.
Occupational therapy focuses on safer ways to complete daily tasks 6. It may help reduce stress from work or household movements 6.
The plan should match the affected body area. It should also account for nearby tendon damage or other causes 2,3.
Antibiotics and drainage
If infection causes bursitis, treatment includes antibiotics 6,9. A clinician may also remove infected fluid with a needle 9.
For infected elbow bursitis, finish the full antibiotic course 9. Continue for the period prescribed by the clinician 9.
Severe infection may not improve with antibiotics alone 9. Surgery may then be considered 9.
Steroid injections and surgery
A clinician may use a corticosteroid injection for pain and swelling 6. A corticosteroid is a medicine that reduces inflammation.
Injections are not needed for every case. A clinician chooses treatment based on the cause and earlier response.
Surgery can remove the affected bursa 6,8. It is generally considered when other treatment has not worked 6,8.
A provider may consider surgery after symptoms last six months or longer 6. Surgery may also treat a severe infection that resists antibiotics 9.
When to See a Doctor
Some symptoms need assessment instead of home care alone. Contact a healthcare professional in these situations:
If pain disrupts daily tasks, arrange a medical appointment 7.
If the joint does not move well, seek medical assessment 7.
If swelling is severe, contact a healthcare professional 7.
If hip pain lasts several weeks, schedule an evaluation 8.
If symptoms keep returning, ask a clinician about repeated triggers 6.
If fever or chills occur, seek prompt medical care 6,7.
If warmth or skin discoloration occurs, seek prompt medical care 5,6.
If a wound appears over swelling, contact a clinician promptly 5.
If symptoms follow a fall, tell a healthcare professional 1,8.
Prompt assessment matters when infection is possible. A fluid test is needed to confirm infected bursitis 5.
Recovery and Prevention
Expected recovery
Most cases improve within a few weeks 6. Hip bursitis may take several weeks or months to improve 8.
Elbow bursitis often improves within three to six weeks 9. Recovery can take longer when pressure continues on the area 6.
Returning to activity too soon raises the risk of another injury 6. Continued stress may also cause chronic or repeated flare-ups 6.
Follow your clinician’s advice about returning to work or sports. Increase the workload slowly after the area heals.
How to prevent bursitis
Not every case can be prevented 7. Task changes can still lower risk and reduce flare-ups 7.
Use knee pads when work requires frequent kneeling 7.
Use padding to reduce pressure on elbows 1.
Take regular breaks during repeated tasks 7,8.
Mix repeated work with rest or other activities 7.
Learn proper posture for sports and work 8.
Learn safe methods for repeated work tasks 8.
Begin new activities at a slow pace 8.
Warm up and stretch before hard activity 7.
Avoid lying on one hip for long periods 8.
Strengthen muscles that support stressed joints 7.
Maintain a healthy weight to reduce joint stress 7.
A physical therapist can assess movement and strength 2,6. An occupational therapist can help change stressful work methods 6.
Repeated symptoms may mean the same trigger remains 6. Seek care if flare-ups continue despite rest and task changes.
Conclusion
Most uncomplicated cases improve with rest and home care 6. Protecting the area gives the swollen bursa time to heal 6.
Padding, breaks, warmups, and slow activity increases may lower risk 7,8. Strength work can also help protect joints under stress 7.
If fever, warmth, or skin changes occur, seek prompt medical care 5,6. A wound over the swelling also needs prompt assessment 5.
Severe swelling, limited movement, or lasting pain deserves medical review 7,8. A clinician can check for infection and other possible causes 3,5.
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