Bursae are small, fluid-filled sacs that let tendons, muscles and skin glide smoothly over bone. When one becomes irritated, pressing on it or moving the joint can hurt. Physical Medicine & Rehabilitation of NY & CT (PMR) approaches bursitis treatment in two parts: calming the irritated bursa and addressing the pressure, tendon or muscle problem that set it off. We treat bursitis at our offices in Danbury and Brewster, NY.
Where bursitis usually strikes
Hip bursitis
The bursa over the bony point of the outer hip can ache when you lie on that side at night, rise from a low chair or walk uphill. The gluteal tendons beside it are usually part of the problem, which is why our hip pain treatment page covers this as outer hip pain.
Shoulder bursitis
The subacromial bursa sits between the top of the shoulder blade and the rotator cuff. Shoulder bursitis hurts when you raise your arm out to the side or overhead, or lie on that shoulder, usually alongside rotator cuff irritation. See shoulder pain treatment for related problems.
Elbow bursitis
The bursa at the point of the elbow can swell into a soft, golf-ball-sized lump after a knock or long periods of leaning on a desk. It may be nearly painless unless it becomes infected.
Knee bursitis
Kneeling on hard floors, common for tile setters and gardeners, can inflame the bursa in front of the kneecap and cause a squishy swelling. Pain on the inner knee just below the joint, common in runners and people with knee arthritis, may come from the pes anserine bursa.
Causes and symptoms
Bursitis usually follows one of these triggers:
- Repeated pressure from kneeling, leaning on your elbows or lying on one hip
- Repetitive movements, such as overhead work, throwing or long runs
- A fall or direct blow
- Weak or overloaded muscles and tendons nearby, or a change in how you walk
- Arthritis, gout or, less often, infection through a cut or scrape
Expect pain and tenderness right over the bursa, pain with pressure or certain movements, and sometimes visible swelling at the elbow or knee.
When to get urgent care for bursitis
An infected bursa needs antibiotics and sometimes drainage, so don’t wait it out if:
- A swollen bursa becomes hot and red, with or without a fever or chills: see a physician the same day
- Redness is spreading, red streaks run from the area, or you feel generally unwell: go to the ER
- Swelling began after a cut, scrape or puncture over the elbow or knee and is getting worse: see a physician the same day
- Severe pain and swelling follow a fall, or you can’t move the joint: get urgent care to rule out a fracture
Bursitis treatment that targets the cause
Your evaluation sorts out whether the bursa is the main problem or a side effect of a tendon or muscle issue. Your clinician checks exactly where it is tender, tests strength and range of motion, watches how you walk, kneel or reach, and orders X-rays when they would help.
Activity changes
Reducing pressure and repetition gives the bursa a chance to settle: knee pads for kneeling, padding for elbows, a pillow between your knees at night for hip bursitis, and breaks during long stretches of overhead work.
Physical therapy
Physical therapy builds strength in the muscles that control the joint, such as the glutes for hip bursitis or the rotator cuff and shoulder blade muscles for shoulder bursitis. Soft-tissue work can ease nearby muscle tension, and movement retraining can reduce pressure on the bursa.
Physician care when needed
Some cases benefit from a corticosteroid injection, drainage of fluid from a large bursa, or antibiotics for infection. These are medical decisions made by a physician, and we coordinate with your doctor when your bursitis treatment calls for one.
Safe self-care
- Ice the area for 10 to 15 minutes a few times a day while it is sore
- Pad or avoid direct pressure on the bursa
- Keep the joint moving gently so it doesn’t stiffen
- Don’t massage or press on a bursa that is hot, red or swollen
Frequently asked questions
How long does bursitis last?
Many cases settle within a few weeks once pressure and repetitive strain are reduced, although outer hip pain involving the tendons can take a few months, and results vary. Bursitis tends to come back if the cause isn’t addressed, so strengthening and changing how you kneel, lean or sleep are important parts of bursitis treatment.
Is bursitis the same as tendonitis?
No, but they often occur together. A bursa is a cushioning sac, while a tendon connects muscle to bone. At the shoulder and outer hip, the two sit side by side and the tendon is often the main driver, so treatment usually focuses on strengthening the tendon and nearby muscles.
Should I get a cortisone shot for bursitis?
A corticosteroid injection can ease bursitis pain for a while, especially when pain disrupts sleep or exercise. It does not change the pressure or weakness behind the problem, and repeated injections carry risks, so it is usually combined with rehab. That decision is one to make with a physician.
Schedule a bursitis evaluation
To start bursitis treatment, reach our Danbury team at (203) 744-8013, our or our Brewster team at (845) 279-1135, or request an appointment online.