Overview
Bursitis (general) is inflammation or irritation of a small fluid-filled sac called a bursa, which helps reduce friction between bones, tendons, and skin around a joint. It most often occurs near major joints where tissues glide under pressure, including the shoulder, hip, elbow, and knee. When the bursa becomes inflamed, it can cause localized pain, swelling, and stiffness, especially with movement or direct pressure. In some cases, bursitis can become infected, which requires prompt evaluation.
Symptoms
Patients usually notice aching or sharp pain in the affected area that may worsen when moving the joint or pressing directly on the tender spot. Swelling and warmth may be present over the bursa, sometimes with visible lump-like thickening. Range of motion can feel limited due to pain, and some people develop sleep disruption when lying on the painful side. If infection is involved, symptoms may include increasing redness, fever, and feeling generally unwell.
Causes
Bursitis commonly develops from repetitive overuse, friction, or prolonged pressure that overloads the bursa. Sudden trauma, falls, or direct impact can also trigger inflammation. Less commonly, gout or rheumatoid arthritis can inflame bursa tissue, and bacteria can cause septic bursitis after skin injury or spread from elsewhere.
Risk Factors
Risk is higher with jobs or hobbies that involve repetitive shoulder or arm motions, kneeling, leaning, or frequent pressure on a joint. Poor training habits, weak supporting muscles, and sudden increases in activity can also contribute. Certain medical conditions such as diabetes or weakened immunity increase the risk of more severe bursitis or infection. Age-related tendon and tissue degeneration can make bursa irritation more likely during everyday use.
Prevention
You can reduce risk by using pacing and gradual progression for exercise and work tasks, avoiding sudden spikes in repetitive motion. Protect the joint from direct pressure using padding, changing positions regularly, and improving ergonomics. Strengthening and flexibility work for the surrounding muscles, along with good movement mechanics, can decrease friction and overload. If a specific activity repeatedly triggers symptoms, modify technique or duration and allow flare-ups to fully settle before returning.
How the Diagnosis Is Evaluated
A clinician typically starts with a focused history about where the pain is, what movements or pressure worsen it, and whether there has been recent trauma or skin infection. Physical examination often shows a localized tender, sometimes warm or swollen bursa, with pain-limited motion. Imaging is not always required, but ultrasound or X-ray can help exclude other causes like tendon injury or joint problems, and MRI may be used if the diagnosis is unclear. If infection, gout, or another inflammatory cause is a concern, aspiration of bursa fluid and related lab testing may be performed.
Nonsurgical Treatment Options
Initial treatment usually focuses on reducing irritation with relative rest from painful activities and avoiding direct pressure on the area. Ice or heat, along with short-term anti-inflammatory medicines such as NSAIDs (when appropriate), can help control pain and swelling. Physical therapy may be recommended to improve joint mechanics, restore comfortable range of motion, and strengthen the muscles that stabilize the joint. If symptoms persist or are significantly limiting, a corticosteroid injection into the bursa may reduce inflammation, and aspiration may be used when fluid is present to relieve pressure or evaluate infection. In select cases, clinicians may consider platelet rich plasma (PRP) injections as a longer-term option, though results vary and evidence is still evolving.
When to Seek Medical Attention
Seek prompt medical evaluation if you have fever, rapidly increasing redness or warmth, severe swelling, or you feel unwell, because septic bursitis must be ruled out. Get urgent care if you cannot use the joint normally, cannot bear weight when the lower extremity is involved, or if pain is worsening quickly despite rest. Contact a clinician soon if pain persists beyond about 1 to 2 weeks, repeatedly returns, or limits sleep and daily activities. Seek immediate care for new numbness, progressive weakness, or other neurologic symptoms.
Frequently Asked Questions
Bursitis often feels like localized pain over a tender spot that gets worse with movement or pressing on the area, and it may come with swelling or warmth.
Tendon problems are usually more related to specific forceful movements, while bursitis typically causes tenderness that is most pronounced over the bursa with direct pressure.
Yes, bursitis can become infected, especially if there is a skin break or spread from nearby infection, and it often causes worsening redness, warmth, and sometimes fever.
Next Steps
If your pain is mild and you can move the joint, start with activity modification, protecting the area from pressure, and symptom relief while monitoring progress over the next 1 to 2 weeks. If symptoms are severe, worsening, involve fever or significant redness, or keep returning, arrange a clinical evaluation to confirm the cause and guide targeted conservative treatment.