Bursitis occurs when the fluid sacs or bursae that cushion muscles, tendons and bones near the joints become inflamed. 

Bursitis occurs most commonly in the shoulder, elbow and hip joints, but it can also affect the knee, heel and/or base of the big toe. 

Bursitis causes include doing repetitive motions, for example in sports such as cricket or baseball, and activities like lifting, leaning for long periods on the elbows, kneeling for various tasks (gardening, cleaning), and sitting for too long. 

Age is also a risk factor, as is rheumatoid arthritis, gout, infection and trauma to the area, such as an injury. 

What are its symptoms?

Bursitis symptoms include the following:

  • Pain in the affected joint that increases with pressure or use
  • An achy or stiff feeling in the joint
  • More pain when you use the joint or if you press it
  • An appearance of swelling, redness, bruising or rash in the affected area
  • Immobility in the affected joint, for instance, ‘frozen shoulder’

It is advisable to see your healthcare professional when the pain become disabling, if it lasts for more than two weeks or is accompanied by a fever. 

How is it diagnosed? 

Your healthcare professional can usually diagnose bursitis from a physical examination and your medical history. 

If necessary, imaging texts, such as an X-ray may be performed. Although an X-ray cannot conclusively diagnose bursitis, it may rule out other reasons for your pain or discomfort.

An ultrasound or MRI (magnetic resonance imaging) may be used if bursitis cannot be diagnosed from a physical exam alone. An analysis of the fluid in the inflamed bursa may be done to find out what is causing the pain and inflammation. 

What are your treatment options? 

Bursitis treatment includes the following:

  • Resting the affected area
  • Avoiding activities that increase pain
  • Placing ice packs on the inflamed joint
  • Taking over-the-counter anti-inflammatory medication. Consult your Clicks pharmacist about suitable medication. 
  • Taking prescribed medication, such as corticosteroids that work fairly quickly to decrease pain and inflammation; a corticosteroid may be injected directly into the site of injury (if there is no infection)
  • Physiotherapy, which would include range-of-motion exercises
  • Antibiotics may be prescribed if the bursitis is caused by infection
  • Surgery may be performed, although this is rare, and only performed when bursitis does not respond to other treatments.

Can it be prevented? 

Although not all types of bursitis can be prevented, there is much you can do to reduce the risks as well as prevent flare-ups, including:

  • When exercising, warm up, and gradually increase repetitions (stop the exercise if unusual pain occurs).
  • If you kneel frequently, use kneeling pads to help reduce pressure on the knees.
  • Bend your knees to pick up objects; this helps reduce stress on the bursae in your hips.
  • Where possible, use a device to help you move objects, for example a cart or dolly.
  • Take regular breaks from repetitive tasks.
  • Avoid sitting for long periods of time, especially on hard surfaces; get up to stretch and walk around.
  • Maintain a healthy weight.
  • Take part in an exercise you enjoy – this will help strengthen muscles, which in turn helps protect joints.

For more info

For more information on inflammatory diseases, contact The Arthritis Foundation of South Africa.

The accuracy of this information was checked and approved by physician Dr Thomas Blake in December 2015