What is bursitis?

Bursitis is an inflammation or irritation of the small, fluid filled ‘cushions’ that protect a tendon where it touches a bone. These cushions are called bursae (or bursa if there’s just one).

When you move your joints, the tendons (which link muscles to bones) slide over the bones. The bursae minimise any friction (rubbing together).

Muscles are connected to bones via strong white fibrous cords called tendons. Wherever these tendons cross bones and joints, you have a small cushion filled with fluid, which is known as a bursa.

When a bursa becomes irritated or inflamed, it swells with fluid and the swelling can be painful and restrict movement.

Bursitis is a common cause of joint pain and swelling. It is most common in the knee and shoulder, but also happens in the hip, elbow, wrist, ankle and heel.

What are the types of bursitis?

Types of bursitis which commonly affect different areas of the body include:

• trochanteric bursitis — hip
• olecranon bursitis — elbow
• pre-patellar bursitis — knee
• retrocalcaneal bursitis — heel
• subacromial bursitis — shoulder
• ischial bursitis — bottom or buttock

What are the symptoms of bursitis?

Feeling joint pain when you move is often the first symptom of bursitis. The area may also be swollen, feel warm or look red. As it gets worse, you might even feel pain when you don’t move the joint.

The swollen bursa can make the joint stiff and its movement might be restricted.

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What causes bursitis?

Bursitis is commonly caused by overuse of a joint, especially by doing the same movements many times. The movements might be through work, such as sitting for long periods of time at work, because of your hobbies, such as gardening, or through sport, such as playing tennis.

Bursitis can also be caused by an injury to the joint, and by conditions that cause swelling such as gout and rheumatoid arthritis. Diabetes can also be a cause.

How is bursitis diagnosed?

Your doctor will do a physical examination and ask about your medical history. They might also recommend tests, including:

• an x-ray to look for other possible causes
• an ultrasound
• taking a sample of the fluid to determine if infection is present

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How is bursitis treated?

Bursitis can often be treated at home, especially if you can avoid the activity that might have triggered it.

It usually improves with ‘RICE’:

• Rest
• Ice packs
• Compression
• Elevation

Over-the-counter pain relief medicines can help manage the pain. Ibuprofen and other non-steroidal anti-inflammatory medicines will also reduce swelling.

If that doesn’t help, a doctor or physiotherapist may recommend gentle exercises and stretches, or a brace. You might need antibiotics if the bursa is infected.

For severe pain, your doctor might refer you to a specialist radiologist for an injection of corticosteroid medicine into or around the bursa.

In some cases, your doctor might recommend surgery to remove or drain the bursa.

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Can bursitis be prevented?

While you might not be able to prevent bursitis, you can prevent flare-ups by making changes to how you normally move. Depending on which joint is affected, you could prevent recurrence of bursitis by:

• avoiding or changing how you carry out the repeated activity
• taking breaks and doing stretches during the day
• maintaining good posture
• wearing the right footwear

Your doctor, physiotherapist or occupational therapist can give you specific advice, including how to:

• ensure your work environment is ergonomically suitable
• warm up and cool down with stretches before sport
• exercise to strengthen muscles around the joint

When should I see my doctor?

In many cases, you can manage bursitis yourself. However, you should see your doctor, occupational therapist or physiotherapist if you have painful, stiff and swollen joints and a fever, or if your symptoms persist for more than 2 weeks.

Resources and support

Find further information on bursitis from Musculoskeletal Australia or call 1800 263 265 (Mon – Fri, 09:00 – 17:00).

Call healthdirect on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available 24 hours a day, 7 days a week.