You’ve tried a new sport or done some DIY—and suddenly a joint starts to hurt. This is often caused by bursitis, a painful but usually harmless condition.
It manifests as swelling in the affected area, along with pain, redness, and warmth. Bursitis is usually caused by injuries or overuse, as well as by conditions such as gout, osteoarthritis, or rheumatism. When properly diagnosed and treated, the symptoms can be quickly alleviated.
Find out here which doctor treats bursitis, what symptoms and treatments are important, and what you need to know about the treatment and prevention of bursitis.
What are bursae, and why do they become inflamed?
Bursae (bursa synovialis) are small sacs made of connective tissue that are filled with fluid. They are found throughout the human body wherever there is increased mechanical stress. Their purpose is to absorb pressure, reduce friction, and thereby protect tendons, muscles, bones, and skin. If this mechanical stress becomes excessive, inflammation occurs.
Bursae can become inflamed at any joint in the body.
About 160 bursae are responsible for ensuring pain-free movement in the body. For example, bursae are found in the shoulder joint, the hip, and the ankle joint of the foot. Theoretically, any bursa can become inflamed. However, bursitis occurs particularly frequently in areas or joints subject to high stress, such as the shoulder, hip, elbow, foot and heel, or knee. Bursitis (ICD code: 71.9) can have various causes.
Depending on the location, doctors refer to it, for example, as olecranon bursitis at the elbow, subacromial bursitis at the shoulder, or bursitis at the knee.
What are the causes and risk factors for bursitis?
In many cases, excessive pressure is the cause of bursitis. In particular, repetitive and/or prolonged activities that exert pressure on the bursa can trigger inflammation. These activities include, for example, laying tile or carpet, sitting for long periods on hard chairs, endurance sports such as long-distance running, and frequently leaning on the elbows. Tile setters and other occupational groups that work on their knees or while leaning on their elbows are therefore more frequently affected.
This pressure irritation leads to what are known as microtraumas. These microscopic injuries trigger an inflammatory response in the affected structure.
Similarly, more severe injuries and trauma—such as those resulting from accidents—can contribute to the development of bursitis. In the case of an open wound, bacteria and other pathogens can enter the wound and infect the bursa. However, this type of bacterial bursitis is relatively rare. More commonly, bursitis results from a blow or impact. As a result of the accident, the bursa fills with blood and subsequently becomes inflamed.
A common cause remains chronic mechanical irritation. If acute bursitis is not treated adequately or if the stress on the joint persists, chronic bursitis can develop.
What are the symptoms of bursitis?
Typical symptoms include redness, swelling, and warmth in the area around the bursa—these are typical signs of inflammation and the main symptoms of bursitis. Since it is primarily the bursae near the joints that become inflamed, patients experience pain in the joint. The joints are tender to pressure, and the pain worsens with movement.
If the inflammation spreads beyond the bursa, the surrounding tissue structures and regional lymph nodes may also swell. Other signs of severe and/or bacterial bursitis include:
- fever,
- fatigue,
- exhaustion, and
- general malaise.
The symptoms of bursitis vary depending on its location. Bursitis of the elbow is often noticeable as a firm, clearly visible swelling. Bursitis of the knee or the kneecap causes pain when kneeling, walking, or climbing stairs. Bursitis of the Achilles tendon can cause discomfort in the heel, and bursitis of the shoulder may result in severe pain when lifting the arm.
How is bursitis diagnosed?
During a detailed medical history interview, the doctor asks about the specific symptoms. Of particular interest are the nature of the pain, as well as physical activities, occupational duties, pre-existing conditions, or accidents that may have triggered the inflammation.
Following the assessment of symptoms and medical history, the doctor will perform a physical examination. During this examination, the doctor will pay attention to
- areas that are tender to the touch,
- whether the area is swollen,
- redness, and
- excessive warmth.
If the causes of the inflammation remain unclear or if bursitis occurs repeatedly for no apparent reason, further tests may be performed. Changes in joint and bone structures can be detected through an X-ray. A blood test also helps identify systemic conditions such as gout, rheumatism, or an infection.
An ultrasound can show whether fluid has accumulated in the bursa. Other imaging techniques are also available. If bacterial inflammation is suspected, the doctor may draw fluid from the bursa for testing.
Treatment and Management of Bursitis
The type of treatment depends on the cause, severity, and course of the condition.
First Aid: Rest and Cold
To avoid further irritating the inflamed bursa, the affected area is temporarily immobilized. However, to prevent functional or mobility limitations, joints should not be rested for too long.Cooling ointments, ice packs, or cold compresses can relieve inflammation and help reduce swelling. Anti-inflammatory and pain-relieving medications, such as ibuprofen or diclofenac, can also help alleviate symptoms. Pain relievers should be used as recommended by a doctor.
Aspiration to Remove Fluid Accumulation
Although simple bursitis can usually be treated effectively, fluid buildup may persist. This manifests as painless swelling. During a puncture, the doctor uses a cannula to drain the fluid and then injects anti-inflammatory cortisone into the bursa. A temporary compression bandage is applied to prevent further fluid buildup.Bacterial bursitis: Surgery and antibiotics
Bacterial bursitis requires special treatment. The doctor must surgically open the bursa to remove the pus from inside it. In addition, patients with a bacterial infection usually need to take antibiotics. In rare cases, complete surgical removal of the bursa may be necessary.If the bursitis is caused by another condition, such as osteoarthritis or gout, treatment is based on that underlying condition. Only by treating the underlying condition at its root can the risk of recurrent bursitis be reduced.
How long does it take for bursitis to heal?
The course and duration of bursitis depend on the cause, severity, and treatment of the condition. With appropriate treatment, uncomplicated bursitis heals without complications within four to six weeks.
Consistent rest, taking anti-inflammatory medications, and regular icing and massage can positively influence the healing process and shorten the duration of the condition.
Specialists
The first point of contact is often the primary care physician. In cases of severe symptoms, an unclear diagnosis, suspected infection, recurrent episodes, or functional limitations, the primary care physician will usually refer the patient to an orthopedic specialist or a rheumatologist.
Preventing Bursitis
You can also take steps in your daily life to support your joints and bursae. Make sure to engage in regular exercise appropriate for your health condition that does not overexert you, and seek guidance when starting new sports or fitness training to prevent improper strain.
For activities that require kneeling, use padding; when working at a desk, use a suitable support and avoid leaning on your knees for extended periods.
Maintaining a healthy body weight also reduces strain on your joints. Ginger and turmeric, among other things, are considered to have anti-inflammatory properties. While they are not a substitute for medical treatment, they can be part of a balanced diet. Anyone experiencing recurring symptoms should consult a doctor early on to determine whether bursitis is developing or if there are other underlying causes.
Frequently Asked Questions
What is bursitis?
Bursitis is a painful inflammation of the bursa. The bursa swells due to an accumulation of fluid. This causes pain, tenderness, redness, and limited range of motion.
How long does bursitis last?
Uncomplicated bursitis often resolves within 4–6 weeks with rest and appropriate treatment. If the condition is caused by ongoing strain, underlying medical conditions, or an infection, recovery may take longer.
What provides quick relief for bursitis?
Rest, cooling, reducing strain, and anti-inflammatory medications usually help. It’s important not to further irritate the affected joint. If you experience severe pain, fever, or increasing redness, you should see a doctor to determine whether the inflammation is caused by a bacterial infection.
Is heat or cold better for bursitis?
For superficial, acutely painful bursitis, cold therapy is often helpful. It can reduce pain and swelling. Heat may be more comfortable for some deeper-seated symptoms, but should not be used without consulting a doctor if bacterial inflammation is suspected.
When is surgery necessary for bursitis?
Surgery is rarely necessary; it may be considered if there is severe purulent inflammation, if symptoms keep recurring despite treatment, or if there is a chronic change in the bursa.
Can bursitis heal on its own?
Yes, mild cases can heal with consistent rest, cooling, and relief of pressure. If symptoms worsen or persist for a longer period, a medical evaluation should be sought.
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Sabine Schneider
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Sabine Schneider – medical author: Explore expert articles and medical expertise in the Leading Medicine Guide.
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