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Education2026-03-04•7 min read

Bursitis: What It Is, Why It Happens, and How to Treat It

What Is a Bursa?

Throughout your body, small fluid-filled sacs called bursae cushion the spaces between bones, tendons, and muscles. They reduce friction and allow smooth movement.

When a bursa becomes inflamed—bursitis—it swells, causes pain, and makes movement uncomfortable. It's one of the most common causes of joint pain.

Common Types of Bursitis

Hip Bursitis (Trochanteric Bursitis)

Location: Outside of the hip, over the bony prominence (greater trochanter).

Symptoms:

  • Pain on the outside of the hip
  • Pain lying on affected side
  • Pain walking, climbing stairs
  • Tenderness when pressing on the area

    • Common causes:

  • Repetitive activities (running, cycling)
  • Prolonged standing
  • IT band tightness
  • Hip muscle weakness
  • Direct trauma (fall)

    • Shoulder Bursitis (Subacromial Bursitis)

    Location: Under the roof of the shoulder (acromion), above the rotator cuff.

    Symptoms:

  • Pain with overhead reaching
  • Pain sleeping on affected side
  • Pain on side/front of shoulder
  • Weakness with arm elevation

    • Common causes:

  • Repetitive overhead activities
  • Shoulder impingement
  • Rotator cuff weakness
  • Poor posture

    • Knee Bursitis

    Prepatellar bursitis: Front of kneecap. Often from kneeling ("housemaid's knee").

    Pes anserine bursitis: Inside of knee, below joint. Common in runners and those with knee arthritis.

    Symptoms:

  • Localized swelling
  • Pain with pressure or movement
  • Warmth over the area

    • What Causes Bursitis?

    Repetitive motion: Same movement over and over irritates the bursa.

    Pressure: Prolonged pressure on a bursa (kneeling, leaning on elbows).

    Trauma: Direct hit to the area.

    Muscle imbalances: Weakness or tightness changing joint mechanics.

    Age: Bursae become less resilient over time.

    Other conditions: Arthritis, gout, infection can cause or worsen bursitis.

    Treatment

    Acute Phase (First 1-2 Weeks)

    Rest from aggravating activities:

  • Avoid the specific movements or positions that cause pain
  • Don't stop all movement—gentle activity is fine

    • Ice:

  • 15-20 minutes several times daily
  • Reduces inflammation and pain

    • Compression:

  • For accessible areas (knee)
  • Helps reduce swelling

    • NSAIDs:

  • Ibuprofen or naproxen can help
  • Short-term use (1-2 weeks)
  • Check with doctor if you have contraindications

    • Protect the area:

  • Knee pads if you must kneel
  • Cushion when lying on affected hip
  • Avoid direct pressure

    • Rehab Phase (Weeks 2-6+)

    Once acute inflammation settles, address the underlying causes.

    Hip bursitis:

  • Strengthen glutes (bridges, clamshells, side-lying leg raises)
  • Stretch IT band and hip flexors
  • Address running/walking mechanics
  • Gradual return to activity

    • Shoulder bursitis:

  • Rotator cuff strengthening
  • Scapular stability exercises
  • Improve posture
  • Address impingement factors

    • Knee bursitis:

  • Strengthen quadriceps and hamstrings
  • Address any biomechanical issues
  • Avoid prolonged kneeling
  • Use protection if kneeling is necessary

    • Medical Treatment

    If conservative treatment fails after 4-6 weeks:

    Corticosteroid injection:

  • Reduces inflammation quickly
  • Provides temporary relief
  • Should be combined with rehab
  • Limited number of injections recommended

    • Aspiration:

  • For significant swelling
  • Removes excess fluid
  • Can be combined with injection

    • Physical therapy:

  • Guided exercise program
  • Manual therapy
  • Modalities for pain relief

    • Surgery:

  • Rare, last resort
  • For chronic, refractory cases
  • Removal of the bursa

    • When to See a Doctor

  • Severe pain or rapid swelling
  • Fever with joint pain (possible infection)
  • Redness and warmth over the area
  • No improvement after 2-3 weeks
  • Recurrent episodes
  • Significant functional limitation

    • Red flag: Septic (infected) bursitis is a medical emergency. Signs include fever, severe pain, spreading redness, and feeling unwell.

    Prevention

  • Strengthen muscles around commonly affected joints
  • Maintain flexibility
  • Use proper form during exercise
  • Take breaks from repetitive activities
  • Use padding when kneeling or leaning
  • Address biomechanical issues early

    • The Bottom Line

    Bursitis is painful but usually responds well to conservative treatment. The key is:

    1. Calm the acute inflammation (rest, ice, NSAIDs)

    2. Address underlying causes (strengthen, stretch, modify activities)

    3. Return gradually to full activity

    4. Prevent recurrence with ongoing maintenance

    Don't just wait for it to go away—treat the inflammation AND fix why it happened.

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