What is a bursa?

Bursitis is an inflammation or irritation of the small, fluid-filled ‘cushions’ that protect a tendon where it touches a bone. These cushions are called bursae (or bursa if there’s just one).

When we move our joints, the tendons (which link muscles to bones) slide over the bones. The bursae minimise any friction.

Muscles in our bodies are connected to the bones via strong white fibrous cords called tendons. Wherever these tendons cross bones and joints, the body creates a small cushion filled with fluid, which is known as a bursa.

When a bursa becomes irritated or inflamed, it swells with fluid and the swelling can be painful and restrict movement.

Bursitis is a common cause of joint pain and swelling. In many cases, you can manage it yourself. If the pain persists, your doctor or physiotherapist can help.

What are the symptoms of bursitis?

Experiencing joint pain when you move is often the first symptom of bursitis. The area may also have swelling, feel warm or look red. As bursitis progresses, you might even feel pain when at rest.

The swollen bursa can make the joint stiff and its movement might be restricted.

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What causes bursitis?

Bursitis is commonly caused by overuse of a joint, especially by doing repetitive movements. The movements might be through work, such as kneeling to clean or garden, or through sport, such as playing tennis.

Bursitis can also be caused by an injury to the joint, and by conditions that cause swelling such as gout and rheumatoid arthritis. It is most common in the knee and shoulder, but also occurs in the hip, elbow, wrist, ankle and heel.

How is bursitis diagnosed?

If you have a painful, stiff and swollen joint that feels warm, you might have bursitis.

You should see your doctor or physiotherapist if you have a fever (there may be infection) or if your symptoms persist for more than 2 weeks.

Your doctor will do a physical examination and ask about your medical history. They might also recommend tests, including:

• an x-ray to look for other possible causes
• an ultrasound
• taking a sample of the fluid to determine if infection is present

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How is bursitis treated?

Bursitis can often be treated at home, especially if you can avoid the activity that might have triggered it.

It usually improves with ‘RICE’:

• Rest
• Ice packs
• Compression
• Elevation

Over-the-counter pain-relief medications can help manage the pain. Ibuprofen and other non-steroidal anti-inflammatory drugs will also reduce swelling. 

If that doesn’t help, a doctor or physiotherapist may recommend gentle exercises and stretches or a brace. You might need antibiotics if the bursa is infected. 

For severe pain, your doctor might refer you to a specialist radiologist for an injection of corticosteroid medication into or around the bursa. 

In some cases, your doctor might recommend surgery to remove or drain the bursa.

Living with bursitis

Depending on which joint is affected, you could minimise the occurrence of bursitis by:

• avoiding or modifying how you perform the repetitive activity
• taking breaks and doing stretches during the day
• maintaining good posture and wearing appropriate footwear

Your doctor, physiotherapist or occupational therapist can give you specific advice, including how to:

• ensure your work environment is ergonomically suitable
• warm up and cool down with appropriate stretches before sport
• exercise to strengthen muscles around the joint