Bursitis: A Minor Cause, Severe Pain

There are more than 150 bursae in the human body, located wherever muscles, tendons, or skin are subjected to particularly heavy strain. Especially in the shoulders, elbows, hips, knees, and heels, they prevent tissues from rubbing against each other with every movement.

If these small “cushions” are subjected to stress or irritation over an extended period, they respond with inflammation. This causes fluid to accumulate in the bursa, leading to swelling and pain. As a result, the range of motion in the affected joint is often noticeably restricted. 

Bursitis often results not from a single incident but from recurring strain. Occupational activities or sports involving repetitive movements significantly increase the risk.

The most common causes include:

• repeated overhead movements
• prolonged kneeling or frequent leaning on one’s knees
• intense physical exertion
• bruises or injuries
• Improper loading of the joints
• rheumatic diseases
• Gout
• Bacterial infections

It is not uncommon for several factors to occur simultaneously. Poor posture or weakened muscles can also contribute to the development of bursitis. 

Symptoms depend on which bursa is affected. Initially, pain usually occurs only with certain movements. However, as inflammation worsens, the pain may persist even at rest.

Typical symptoms include:

• sharp or pulling pain
• Pain on pressure over the affected joint
• visible swelling
• Warmth
• skin redness
• Limited range of motion
• Pain when lying on the affected side

If a bacterial infection is also present, fever, chills, and a general feeling of illness may occur. In this case, medical attention should be sought promptly. 

Bursitis can occur in any joint. However, certain areas of the body are particularly susceptible. It often develops in the shoulder due to repetitive overhead movements or sports-related strain. In the elbow, constant leaning on the joint is a typical cause. In the knee, it frequently occurs in people who kneel a lot for work—such as tile setters, gardeners, or floor installers. Bursitis can also cause severe pain in the hip. This is particularly noticeable when walking, climbing stairs, or lying on the affected side of the body. 

The description of the symptoms alone provides important clues. The affected joint is then examined for swelling, tenderness, or limited range of motion. In addition, imaging techniques such as ultrasound or magnetic resonance imaging (MRI) may be used. These show whether the bursa is enlarged or inflamed and help rule out other causes of the symptoms.

If bacterial inflammation is suspected, fluid can be drawn from the bursa and analyzed in a laboratory. 

Treatment depends on the cause and severity of the inflammation. In many cases, it is sufficient to rest the affected joint for a while and take anti-inflammatory medications. In addition, ice therapy, physical therapy, or targeted exercises can help relieve pain and restore mobility. If symptoms persist, cortisone injections may be considered.

If a bacterial infection is present, antibiotics are prescribed. Surgery is rarely necessary, such as when the inflammation keeps recurring or other treatments are ineffective. 

In daily life, there are several things you can do to support healing and prevent bursitis from recurring.

The following measures, among others, are helpful:

• Temporarily reducing movements that put strain on the joint
• regularly applying cold to the joint
• Avoiding one-sided strain
• Establishing ergonomic work procedures
• Targeted muscle strengthening
• Gradually increase the level of activity

Anyone who repeatedly suffers from bursitis should work with their treating physician to identify possible causes. Often, even small changes in daily life can prevent symptoms from recurring.

Bursitis can significantly limit daily activities and make even simple movements painful. In most cases, however, it heals without causing permanent damage. It is crucial not to overuse the affected joint and to treat the underlying cause of the symptoms specifically. This can alleviate pain and often prevent recurrent inflammation.