If you have twinges (or should we say bursts) of pain, stiffness and swelling near one of your joints, it might be a condition called bursitis. This condition affects the fluid-filled cushions (bursae) around your joints and is more common where you move your body the most – for example, your shoulders, elbows, hips and knees. The main causes of bursitis include repetitive motions, injury and infection.

Bursitis is often confused with other conditions, and you’ll need to talk with a doctor to find out if your pain is caused by bursitis or something else. Read on to learn about bursitis, its symptoms, available treatments and when to seek care.

Bursitis is a condition that affects the padding around your joints that are known as bursae

Bursae are small, fluid-filled pads that surround your joints. If you have bursitis, it means you have a bursa (singular for bursae) that’s inflamed.

Normally, these pads work as a cushion between your joints and the surrounding bones, muscles and tendons – and they help the different parts of your joints glide and slide past one another. They also absorb the pressure caused by your body’s movements.

If there’s too much friction between a bursa and the surrounding area, the bursa can get irritated and inflamed. The bursa responds by getting thicker and producing more fluid so there’s more cushioning for your movements. However, if the bursa gets too big, it can lead to pain and make movements difficult. Bursa inflammation can also be caused by an infection.

Certain joints are more likely to have bursitis than others

You have more than 150 bursae in your body, and it’s possible to get bursitis in any of them – though bursitis is more likely to develop in certain parts of your body. The four most common types of bursitis are shoulder, elbow, hip and knee. But bursitis can also be the cause of heel pain or the reason why your hand hurts.

Common bursitis symptoms include pain and swelling

In most cases, bursitis symptoms develop gradually and are pretty mild. But it’s possible for them to be sudden or more serious. Common bursitis symptoms include:

  • Pain and tenderness that gets worse when you move or apply pressure to the affected area
  • Swelling and redness (if the affected bursa is close to the skin)
  • Joint stiffness that can limit motion
  • Increased discomfort at night since you’ve moved your body all day long

The following are other symptoms based on the location of your bursitis.

Shoulder bursitis symptoms can affect your range of motion

Shoulder bursitis is the most common type of bursitis. The symptoms can start suddenly or get worse over time. You may feel tenderness, a dull ache or a sharp pain in your shoulder. Other symptoms of shoulder bursitis include:

  • A painful or decreased range of motion
  • Sharp or pinching pain that increases when you lift your arms above your head
  • Shoulder pain when lying on your affected side

Elbow bursitis symptoms are more likely to start suddenly

Elbow bursitis often comes with sudden, significant swelling. Other symptoms of elbow bursitis include:

  • Swelling that may not be noticeable since the skin on the back of the elbow is loose
  • Pain when you bend your elbow, though some people don’t have any pain at all

Hip bursitis symptoms depend on the affected bursa

Hip pain is usually the main symptom of hip bursitis. In the early stages of hip bursitis, the feeling can be sharp and intense, but over time, the pain often turns into a dull ache. Where you feel it will depend on which bursa is inflamed.

Trochanteric bursitis in the hip

A common place for hip bursitis is in the bursa that’s on the boney point of the hip bone. This part of the bone is called the greater trochanter. If you get bursitis in this area, it’s called trochanteric bursitis. Symptoms include:

  • Pain at the point of the hip which may extend down to the outside thigh area
  • Pain that’s worse when you lay on the affected hip
  • Pain that is worse when getting up after sitting for a while or after you’ve been walking around a lot

Iliopsoas bursitis in the hip

The iliopsoas bursa is found on the groin side of the hip. This type of hip bursitis causes pain and stiffness on the front of the hip and in the groin area.

Knee bursitis symptoms are felt across the top of the knee

Bursitis can be a cause of knee pain that’s over your kneecap. Common symptoms include:

  • Swelling on the front of the knee
  • A knee that’s tender to the touch
  • Pain when bending your knee or kneeling
  • Knee pain that’s worse at night

What causes bursitis? There are three common reasons

Usually, bursitis is caused by the repetition of normal, everyday activities. Less often, bursitis is caused by an injury or infection.

1. Repetitive stress is the main cause of bursitis

In most cases, bursitis is caused by repetitive low-impact movements that affect the bursae a little bit at a time. Example movements include kneeling, leaning on your elbows, tossing a baseball or playing a musical instrument.

When you do these activities occasionally, your bursae are able to supply the cushioning your body needs for smooth movements. But if you do these activities often or for a long time without taking a break, it causes friction between the bursae and the surrounding area.

2. Trauma to a bursa can also cause bursitis

Bursitis can be caused by direct trauma to a bursa – for example, if you’re knocked in the knee with a hockey stick or you land on your elbow while falling backwards. If you have bursitis caused by trauma, you’ll likely have sudden and significant swelling around the injured area.

3. Bacterial infections can cause more serious bursitis symptoms

Infections are more likely to develop in bursae found just below the skin – these include the ones in your knees and elbows. That’s because it’s more likely for microorganisms to get into the bursae if you have any kind of wound (scrape, puncture or even a bug bite).

If you have septic bursitis, you may have more serious symptoms such as:

  • Skin around the injury that’s red and warm
  • A fever
  • Increased pain

If you think you have an infected bursa, head to urgent care and have it looked at right away.

Health and lifestyle factors can increase your risk of bursitis

Anyone can get bursitis, but you’re more likely to get it if:

  • You have a job or hobby that causes repetitive pressure on a particular bursa, such as gardening, laying carpet or playing a musical instrument
  • You’re over 40 years old
  • You have diabetes, thyroid disease or an inflammatory type of arthritis (such as rheumatoid, gout or psoriatic)
  • You’re overweight

Conditions that can be mistaken for bursitis

Your joints do a lot of work, and there are lots of conditions that can cause pain, swelling and tenderness around them. Because of this, it can be difficult to know if you have bursitis or another condition. Talking to an orthopedic doctor or a physical therapist is the best way to learn what’s causing your symptoms.

Here’s how bursitis is similar and different to other conditions.

Bursitis vs. tendonitis

  • How the conditions are similar: Repetitive motions can cause both tendonitis and bursitis, and the two have similar symptoms. Plus, both occur around joints that are used a lot. This is part of the reason why people often get bursitis and tendonitis at the same time.
  • How the conditions are different: The difference is what part of your anatomy is injured. When a tendon (the connective tissues between muscles and bones) gets irritated or inflamed, it’s called tendonitis. While the symptoms are very similar, pain from tendonitis usually only happens when you’re moving, but bursitis can be painful even when you’re resting.

Bursitis vs. arthritis

  • How the conditions are similar: Both conditions cause joint pain, stiffness and inflammation. And often these symptoms are at their worst at night.
  • How the conditions are different: Bursitis is usually a short-term condition caused by overuse of your joints. Arthritis is usually a long-term condition that happens when a joint’s cartilage breaks down over time. Arthritis also tends to be more painful than bursitis.

Bursitis vs. sprains

  • How the conditions are similar: Both conditions can cause swelling and pain around your joints. And both can be the result of an injury or accident.
  • How the conditions are different: Sprains are injuries to ligaments, which are the tissues that connect bones to other bones. If you have a sprain, you’re likely to have sudden pain and swelling following an accident or an injury. However, if your accident caused bursitis, the affected area would swell but probably wouldn’t be too painful.

Bursitis vs. bone fractures

  • How the conditions are similar: Both conditions can cause pain and swelling near the joints following an accident or injury.
  • How the conditions are different: Fractures (or broken bones) are usually the result of a trauma or accident. Sometimes when a bone is fractured, it’s obvious because there’s a bone poking through the skin or there’s a visible deformity. Other symptoms of a broken bone include a sharp stabbing pain. Bursitis doesn’t generally cause deformity or severe pain.

How long does bursitis last? It’s usually temporary

Bursitis usually goes away after a couple of weeks of home care. But if you don’t treat it, it can take longer to recover and you’re more likely to have chronic bursitis – which means your symptoms keep coming back in the same place. Over time, chronic bursitis can lead to muscle deterioration and reduced range of motion in the affected joint.

So, it’s important to treat your bursitis at home and make an appointment with a physical therapist or orthopedic doctor if your symptoms aren’t improving.

Treatment of bursitis can include self-care and medical options

Treatment of bursitis depends on the cause and your symptoms – but usually starts with bursitis self-care.

You often only need home remedies for bursitis symptoms

The RICE method for treating injuries (rest, ice, compression and elevation) is often used for treating bursitis at home. But if your symptoms are minor, you might not even need to do that much. Here’s what to know about using the RICE method for bursitis.

  • Rest: The number one thing in bursitis self-care​​ is giving the injured area time to rest. So that means using the area as little as possible and definitely staying away from strenuous activities until you’ve healed. You may also consider wearing a splint, sling or brace to support the injured area. If you have knee bursitis, it’s a good idea to place a small pillow between your knees as you sleep.
  • Ice: Applying ice to your injury can help with pain and swelling. If it helps, ice your injury a couple times a day for 20 minutes. If ice doesn’t seem to work, you could try a heating pad instead.
  • Compression: If the area surrounding your bursitis is swollen, compressioncan help. Wrap the affected area with an elastic bandage (such as an ACE wrap).
  • Elevation: Another way to reduce swelling is to elevate your injury. Try to keep the affected area at or above the level of your heart while sitting or lying down.

If you’re feeling pain or discomfort, an over-the-counter anti-inflammatory medicine like ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve) can also help provide relief.

Medical treatments for bursitis can help when home treatments don’t

If bursitis symptoms don’t improve after a couple of days or they get worse after a couple of days of rest and home remedies, it may be time to see an orthopedic doctor or physical therapist. They’ll make sure you get the best treatment for your specific injury, which could include medication, physical therapy and other options.

Prescription bursitis medications

If you’re not able to manage bursitis pain and swelling with over-the-counter medications, your doctors may recommend other medications:

  • Antibiotics: If you have septic bursitis caused by a bacterial infection, your doctor may prescribe an antibiotic.
  • Corticosteroid injections: If your bursitis is causing a lot of pain and swelling, your doctor may prescribe a corticosteroid injection. These injections are most commonly used for hip and shoulder bursitis. In many cases, only one injection is needed.

Physical therapy

Physical therapy, including aquatic therapy, can reduce the pain of your injury and build up your strength, as well as help you to move better and reduce the chance of bursitis coming back.

Physical therapy includes education, targeted exercises and hands-on guidance. Working with a physical therapist or orthopedic doctor is the best way to get a personalized physical therapy plan to help you recover from your specific injury.

If your job or hobbies are causing or contributing to your bursitis, they can help you change how you do activities so that you reduce irritation of the bursae.

Braces and assistive devices

Custom braces and assistive devices can support your body or change your movements to reduce the stress on your body. For example, if you have knee, hip or foot bursitis, your doctor may suggest using crutches while you heal.

Your orthopedic doctor or physical therapist can also provide recommendations for the type of products that will best support your body as you heal. Chances are that you’ll be able to get sufficient support from a brace, sling or assistive device that you buy at a retail store or online. But custom orthotics can be better for knee and foot bursitis.

Surgery for bursitis

Surgery for bursitis is pretty rare. If you have bursitis that’s infected or doesn’t get better with other treatments, your doctor may recommend a procedure to drain fluid from the bursa through a needle.

If the bursa is very damaged, your doctor may suggest surgery to remove the bursa (bursectomy). Removing a bursa doesn’t change how your muscles work, but it can relieve the pain and swelling that comes with bursitis.

When to see a doctor for bursitis symptoms, and who you should see

While bursitis can generally be treated at home, you should make an appointment with a physical therapist or orthopedic doctor if:

  • Your symptoms don’t go away in a couple of days or keep coming back
  • The bursitis is getting in the way of everyday activities
  • The bursitis is very painful when you move or exercise

If your symptoms are more serious, or there are signs that you have an infected bursa, you’ll want to get care sooner. Head to urgent care if:

  • You have a fever
  • You’re unable to move your joint
  • There’s a lot of swelling, redness, bruising or a rash around the affected area