What Is Bursitis?

What Exactly Is A Bursa?

A bursa is a small, fluid-filled sac that helps tissues glide smoothly over each other. It reduces friction, rubbing, and irritation between muscles, tendons, and bones. The human body contains over a hundred bursae, mostly located near major joints like the hips, knees, shoulders, and elbows. When a bursa becomes inflamed, the condition is known as bursitis. This inflammation can affect many bursae throughout the body and arise from various causes.

What Causes Bursitis?

Bursitis usually develops from repetitive movements or minor impacts near a bursa. Over training during exercise or poor posture at work often contributes. Repetition overload or using improper technique can trigger inflammation. A single traumatic event, like a fall, may also lead to bursitis. In my physiotherapy clinic, I frequently see patients develop bursitis after falls onto the hip, knee, or shoulder.

This painful condition is more common in adults, especially those over 40, as soft tissues become less elastic and more prone to injury with age.

Other causes include:

• Infection: A scraped knee can introduce bacteria into the prepatellar bursa, leading to septic bursitis.
• Gout: Crystal deposits can inflame the elbow bursa, causing olecranon bursitis. This often results in visible swelling at the elbow tip.
• Rheumatic conditions: Diseases like rheumatoid and psoriatic arthritis can increase the risk of bursitis.

Where In The Body Does Bursitis Occur?

Bursitis can affect various parts of the body. In my practice, I most often see it in the:

• Shoulder
• Hip
• Knee
• Heel
• Elbow

What Are the Symptoms?

Pain is the most common symptom of bursitis. It may develop gradually with overuse or come on suddenly after trauma. In overuse cases, pain tends to worsen over time. Traumatic bursitis, on the other hand, often causes immediate or rapid-onset pain.

Symptoms can range from mild discomfort to severe, debilitating pain. When pain is intense, joint movement may become limited. For instance, someone with shoulder bursitis might struggle to lift their arm above shoulder height or even bring it near that level.

How Is It Diagnosed?

A physiotherapist or doctor usually diagnoses bursitis through a detailed history and physical examination. Typical signs include pain, swelling, and tenderness over the bursa. Movement of nearby joints may be restricted or painful. Physiotherapists often use specific tests to confirm the condition and rule out other possible issues.

Additional diagnostic tools may include:

• X-rays: Useful in chronic or recurrent cases to check for calcification and bony abnormalities. For example, a hooked acromion in the shoulder can compress the bursa during overhead activity.
• Ultrasound or MRI: These imaging techniques are excellent for examining soft tissues like bursae and confirming a diagnosis.
• Lab tests: When infection is suspected, fluid from the bursa may be sent for analysis.

What Is The Treatment For A Bursal Issue?

Treatment varies depending on the cause. For non-infectious bursitis, common strategies include:

• Activity modification: Avoid movements that irritate the bursa. Continued aggravation slows recovery.
• Relative rest: Sometimes more rest is needed beyond avoiding specific activities. However, full immobilisation is usually discouraged and kept brief if necessary.
• Ice therapy: Helps manage pain and may reduce inflammation.
• Anti-inflammatory medication, either topical or oral.
• Physiotherapy: Targeted rehab can reduce pain, restore mobility, and prevent recurrence.
• Cortisone injections: Especially useful for traumatic bursitis or when conservative measures don’t help.
• Surgery: Rare but may be necessary for persistent or severe cases unresponsive to other treatments.

Septic bursitis is less common but more serious. A lab can test fluid from the bursa to identify infection. Treatment typically includes antibiotics, often given through an IV. In some cases, doctors may need to drain the bursa repeatedly or surgically remove it (a bursectomy).

Can Bursitis Be Prevented?

Yes, gradual progression in activity can help. If you’re starting a new exercise or task, build up slowly. Increase repetitions, duration, or frequency over time to let your tissues adapt. Always pay attention to pain—especially if it’s new, persistent, or localised and seek professional advice from your doctor or physiotherapist.

Disclaimer: Sydney Physio Clinic does not endorse any treatments, procedures, or products mentioned. This information is provided for education and is not a substitute for medical advice. Anyone seeking assistance regarding bursitis should consult their GP, orthopaedic surgeon, sports medicine specialist, or physiotherapist.