What is Bursitis?

Bursitis is an inflammation (“-itis” means inflammation) of the bursa, which are small sacs filled with a jelly-like substance that is found in the joints of the elbow, shoulder, hip, knee, and heel.

In a healthy joint, the jelly substance acts as a cushion and helps reduce the friction of movement between the bones and other parts, like the muscles, tendons, or even the skin. When the bursa become inflamed, it can cause significant pain and swelling.^1,2

How does bursitis form?

Bursitis can occur from an injury to the joint or from repetitive stress or overuse. Repetitive stress can occur from doing the same activity over and over, like stair climbing, standing for long periods, kneeling for cleaning or gardening, or resting on your elbows for long periods.

Some conditions increase your risk for developing bursitis, including rheumatoid arthritis, gout, and diabetes. The risk of bursitis also increases with age, and being overweight can add stress to the knees and hips, which can increase the risk of bursitis in those joints.³

How is it diagnosed?

Bursitis is often diagnosed through a medical history and a physical exam by a doctor. Occasionally, additional tests may be used, such as x-rays, ultrasound, magnetic resonance imaging (MRI), or blood tests. Sometimes, a doctor will remove a small amount of fluid from the joint to test for an infection.^2,3

Understanding the difference

It can be difficult to tell the difference between bursitis and psoriatic arthritis (PsA), and in fact, it is possible for someone with PsA to also have bursitis.

The pain from bursitis may increase when pressure is put on the joint, and the pain may be worse after a long time of inactivity (like sitting for a long time or sleeping) or after repetitive activity.

PsA often involves pain and swelling in the joints as well as additional symptoms such as reduced range of motion, general fatigue, swollen fingers or toes, and changes to the nails.^4,5

Treatment options

Treatment for bursitis includes resting the joint (stopping any repetitive actions that have led to the bursitis), pain medications, and/or ice.

Most of the time, bursitis will get better over time. However, some people need additional treatment, including antibiotics (to deal with any infection), physical therapy, injections of corticosteroid into the bursa, temporary use of an assistive device like a walking cane, or rarely, surgery.^1-3

Preventitive measures

There are some steps you can take to reduce the risk of developing bursitis or reduce the severity of a flare-up of bursitis, including:

• Stretching – prior to any exercise, take time to stretch and allow your muscles to warm up
• Use cushions for kneeling – if you will be kneeling for a period of time, such as while gardening or cleaning, use kneeling pads to reduce the pressure on your knee joints
• Keep moving – avoid staying in one position too long, and stay active throughout the week, rather than just exercising on weekends
• Take care with lifting – when lifting heavy objects, bend your knees to reduce the pressure on the hips; if you’re reaching for an object with your arms, face the object rather than stretching sideways or behind you
• If you feel pain, stop – don’t continue to push a joint to work when it’s giving you pain^3,6