Bursitis occurs when the small fluid-filled sac (bursa) found inside joints becomes inflamed. The sac helps to lubricate and cushion the joint, and when it is inflamed movement can be painful. Usually bursitis occurs in larger joints, such as the shoulder, hip, knee, or elbow. Repetitive motion is often the cause. Although bursitis usually goes away in a few weeks with treatment, you can get bursitis once or several times. Without seeing your health care provider, you usually can't easily tell the difference between bursitis and pain caused by a strain or arthritis.
Usually the bursa becomes irritated or injured after overuse from repetitive motion or strenuous activity. Bursitis may also be caused by a bacterial infection. Other health problems, such as gout or rheumatoid arthritis, can also cause bursitis.
Your doctor will ask you where the joint hurts and feel the joint for swelling or tenderness. Your doctor may order an x-ray or remove some fluid from the bursa with a small needle to check for infection. You may also need a blood test to check for other health problems.
Often simply resting and elevating the joint can help the area heal. A splint, sling, or other device can support the joint and keep it from moving. Applying ice or heat may help relieve pain and swelling. Once the joint is no longer painful, you can work to strengthen the muscles around the joint and prevent further flare-ups.
In very rare cases, the bursa is surgically removed.
Alternative therapies may help reduce the pain and inflammation of bursitis while supporting healthy connective tissue.
Eat whole grains, fruits, vegetables, and fatty fish or help reduce inflammation. Avoid processed foods and foods high in sugar and fat. The following supplements may help.
The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, can trigger side effects and can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a healthcare practitioner.
These herbs may help reduce inflammation:
Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies for the treatment of bursitis based on their knowledge and experience. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate treatment for each individual.
Acupuncture can help reduce swelling and inflammation, and especially relieve pain.
Although no well-designed scientific studies have looked at whether chiropractic treatment is effective for bursitis, chiropractors often treat people with this condition. They report that some people experience improvements in symptoms, including reduced pain and increased range of motion. Chiropractors are also likely to use other treatments in addition to spine and joint manipulation (such as ice massage and ultrasound therapy) in treating bursitis.
Exercising the muscles around your joints will help reduce pressure on the joint and bursa. Gentle yoga may help bursitis by increasing flexibility and reducing muscle tension in the area of the bursa. Other movement therapies, such as Pilates and Tai Chi, may also help improve muscle and ligament strength and reduce the tension caused by repetitive motions.
You should not use massage if your bursitis is caused by an infection. Otherwise, massage (especially myofascial release therapy) can help you relax and can reduce the discomfort from a sore joint.
Tell your health care provider if your treatment does not relieve your symptoms. Be sure to follow your doctor’s instructions for resting the joint to allow the swelling to go away.
You can help prevent bursitis from recurring by avoiding repetitive motions, resting between periods of intense activity, and doing stretching exercises before starting an activity.
Do not take aspirin, acetaminophen (Tylenol), or ibuprofen (Advil, Motrin) for more than a few days unless so directed by your provider.
Be sure to tell your health care provider if you are pregnant.
Barker LR, Burton JR, Zieve PD, eds. Principles of Ambulatory Medicine. 4th ed. Baltimore, Md: Williams & Wilkins; 1995:885-894.
Carr AC, Frei B. Toward a new recommended dietary allowance for vitamin C based on antioxidant and health effects in humans. Am J Clin Nutr. 1999;69(6):1086-1107.-1.
Gerber JM, Herrin SO. Conservative treatment of calcific trochanteric bursitis. J Manipulative Physiol Ther. 1994;17(4):250-252.
JAMA Patient Page. How much vitamin C do you need? JAMA. 1999;281(15):1460.
Joe LA, Hart LL. Evening primrose oil in rheumatoid arthritis. Ann Pharmacother. 1993;27:1475-7.
Johnston CS. Recommendations for vitamin C intake. JAMA. 1999;282(22):2118-2119.
Kimmatkar N, Thawani V, Hingorani L, et al. Efficacy and tolerability of Boswellia serrata extract in treatment of osteoarthritis of knee -- a randomized double blind placebo controlled trial. Phytomedicine. 2003;10:3-7.
Klein G, Kullich W. Short-term treatment of painful osteoarthritis of the knee with oral enzymes. Clin Drug Invest. 2000;19:15-23.
Levine M, Rumsey SC, Daruwala R, Park JB, Wang Y. Criteria and recommendations for vitamin C intake. JAMA. 1999;281(15):1415-1453.
Reginster JY, Deroisy R, Rovati L, et al. Long-term effects of glucosamine sulphate on osteoarthritis progression: a randomised, placebo-controlled clinical trial. Lancet 2001;357:251-256.
Schmid B, Ludtke R, Selbmann HK, et al. Efficacy and tolerability of a standardized willow bark extract in patients with osteoarthritis: randomized, placebo-controlled, double blind clinical trial. Z Rheumatol. 2000;59:314-320.
Singh GB, Atal CK. Pharmacology of an extract of salai guggal ex-Boswellia serrata, a new non-steroidal anti-inflammatory agent. Agents Actions. 1986;18:407-12.
Stein JH, ed. Internal Medicine. 4th ed. St. Louis, Mo: Mosby-Year Book; 1994:2400-2404.