A ‘bursa’ is a small fluid-filled sac over the joints that acts as a cushion between the bone and other moving soft tissues, such as the muscles, tendons, or skin.(1) The lubrication provided by a bursa helps reduce friction during movement.
You suffer from bursitis due to inflammation in one or more bursae. It may affect the joints in the shoulder, elbow, hip, knee, heel, or the base of a big toe and cause a lot of pain and discomfort.
In fact, bursitis is a common reason behind orthopedic consultations.(2)
There can be different types of bursitis, such as prepatellar bursitis (affects the kneecaps), olecranon bursitis (affects the elbows), trochanteric bursitis (affects the hips), retrocalcaneal bursitis (affects the heels), and infectious bursitis. (an infection in the bursa)
Causes of Bursitis
The most common causes are repetitive movements or pressure that irritates the bursae. For instance, people who play baseball or basketball who need to throw or lift the ball over their head repeatedly are at a higher risk of having bursitis. Even people who lean on their elbows for long periods or people who play darts a lot are at an increased risk for bursitis in the elbow. Similarly, gardeners, carpet fitters, and housecleaners who spend a lot of time on their knees are at a higher risk for bursitis in the knees. Manual workers are increasingly prone to developing this condition as well due to all those hours of heavy lifting.
Repeated physical stress can cause bursitis in the following areas:
Other causes of bursitis include:
- Injury or some kind of trauma to the affected area.
- Chronic systemic diseases.
- Inflammatory conditions, such as rheumatoid arthritis, scleroderma, and gout.
- Incorrect body posture for extended periods – for instance, at work.
- Septic bursitis is caused by a skin rupture that allows bacteria to enter and cause infection in the bursae nearer to the skin surface, such as those located near the elbow.
- If you throw yourself into a rigorous exercise routine without proper warm-up exercises such as stretching.
Anyone can develop bursitis, but increasing age, being overweight, and suffering from conditions such as arthritis, gout, and diabetes can surely increase your risk.
Signs and Symptoms of Bursitis
Depending on the affected joint, people may experience different symptoms. Some common signs and symptoms include:
- Dull pain
- Warmth and tenderness in the affected joint and adjoining area
- Difficulty using the affected joint
- Fever, in the case of septic bursitis
The symptoms become worse when you try to move or press on the affected joint.
The condition may be chronic or acute. In the case of acute bursitis, the symptoms will appear suddenly, whereas, in chronic bursitis, the symptoms will occur on a regular basis.
Prevention of Bursitis
- Avoid applying any kind of pressure on the affected joint.
- Avoid sitting or standing for prolonged periods of time. Take frequent breaks and walk around.
- Strive to maintain a healthy weight to avoid stress on your joints.
- Perform strengthening exercises to maintain healthy joints and muscles.
- Do warm-up and stretching exercises before doing strenuous activities to protect your joints from shock injury.
- If you are required to spend a lot of time kneeling, such as when gardening or scrubbing floors, always wear protective knee pads.
- Wear properly fitted and supportive footwear. For athletes or avid walkers, investing in a good pair of running or walking shoes is recommended.
- Avoid sudden jerky motions, and gradually increase the weights when doing lifting exercises.
When to See a Doctor
Seek medical help if you experience any of the following symptoms:
- Excessive swelling, warmth, or redness in the affected area
- Sharp or shooting pain
- Inability to move a joint
- Bruising or a rash in the affected area
- Unabated pain that persists for longer than 2 weeks
- Excessive pain and swelling that leads to loss of movement in the affected joint
For treating bursitis, there are some natural remedies and lifestyle tips. Most of these remedies and tips focus on relieving the pain, treating the condition, and preventing recurrent flare-ups.
Here are the top 10 home remedies to reduce pain and swelling for bursitis.
1. Take Rest
Bursitis may be a sign to take it easy and rest your body to reduce pain and swelling. In cases of acute bursitis, it goes away on its own within a week or two with proper rest.
In fact, rest is recognized as the first line of treatment to help the injured or inflamed area get better.
To deal with the pain and inflammation, conservative treatment involves the use of rest as well as ice, compression, and elevation.(3)
Thus, it cannot be stressed enough that once bursitis sets in, you must avoid any exertion on the vulnerable area or activity that may aggravate the damage. This will help the affected area to heal and curb inflammation. Additionally, proper rest will protect the damaged tissues from further injury.
As bursitis causes inflammation, applying an ice compress on the affected area is very beneficial.
The cold temperature helps bring down the initial swelling and reduces pain by numbing the affected area.(4)
Cold compresses are usually most effective when used within 24 to 48 hours of developing bursitis.
- Wrap a few ice cubes in a thin towel.
- Put the ice pack gently on the affected joint for about 15 minutes.
- After removing it, elevate the joint above your heart and rest.
- Repeat a few times a day until you get relief.
Compression also aids in the treatment of bursitis. It helps to reduce swelling by preventing the pooling of fluid that may seep into the affected area from adjacent tissues. This aids in the healing process and prevents further injury.
In a 2016 review published in Clinical Orthopedics and Related Research, researchers analyzed several studies and finally came to the conclusion that compression bandaging along with a short course of NSAIDs can be effective in the treatment of nonseptic olecranon bursitis.(5)
For compression, you can use an ACE wrap or elastic bandage, which are readily available in the market.
- Wrap the bandage using uniform pressure around the affected area. Do not wrap it too tightly as that would constrict or cut off the blood circulation in the affected area and cause further pain.
- Keep the bandage on during the day until the swelling reduces.
- Remove the bandage before you go to sleep.
Keeping the affected area elevated for a few hours daily can also help a lot.(6)
The science behind this technique is that raising the bursitis-ridden joint will help improve the circulation in the area and thereby provide relief from discomforts such as swelling, inflammation, and pain. Furthermore, this is a useful method to prevent the accumulation of excess fluid in the affected area as well.
So, if you have bursitis on the knee or hip area, try lying on your bed with your leg propped on at least two pillows.
Similarly, you can keep your shoulder elevated with the help of pillows.
5. Warm Compresses
Forty-eight hours after the onset of acute or chronic bursitis, warm compresses can prove to be very helpful.(4)
The application of heat stimulates blood flow to the affected joint, reduces stiffness, and fights inflammation.
- Dampen a thin towel with warm (not scalding) water.
- Apply it on the affected area for 15 to 20 minutes.
- Repeat a few times a day.
You can also use a hot water bottle or a heating pad as a warm compress. You can even wash the affected area with warm water.
Massage helps reduce the discomforts from a sore joint. It improves circulation and reduces swelling and stiffness. It also works as a much-needed respite for your mind and body by inducing an overall sense of relaxation.
Even experts suggest that massage therapy is effective at improving shoulder pain or any other kind of muscle or joint pain.(7)
You can massage the affected joint yourself or get it done by an expert.
- Heat up some olive, coconut, sesame, or mustard oil.
- Apply the warm oil on the affected area.
- Massage using gentle yet firm pressure for 10 minutes.
- Put a warm towel on the affected area.
- Repeat a few times daily until your condition improves.
Ginger is a natural analgesic that can help reduce the pain and discomforts of bursitis. In fact, parallels are drawn between its anti-inflammatory and analgesic qualities and that of conventional NSAIDs such as aspirin or ibuprofen. This is a telling indicator of ginger’s potency and effectiveness as a pain reliever.(8)
To further add to its therapeutic merits, ginger also helps improve blood circulation, which can put you on the fast track to complete recovery.
- Wrap 3 to 4 tablespoons of freshly grated ginger in a piece of cheesecloth and tie it tightly. Put this in hot water for 30 seconds. Allow it to cool, then place it on the affected joint for 10 minutes. Do this 2 or 3 times a day.
- Another option is to massage the affected area with ginger oil a few times daily.
- Also, boil 1 tablespoon of sliced ginger in 2 cups of water and let it simmer for 10 minutes. Strain, add raw honey to taste and drink it 2 or 3 times a day.
The yellow pigment called curcumin in turmeric is a very effective anti-inflammatory agent.
This was corroborated by a 2017 study published in the Journal of Traditional and Complementary Medicine that found curcumin naturally endowed with anti-inflammatory properties.(9)
Hence, the turmeric resting in your kitchen cabinet can come quite in handy in reducing the pain, swelling, and inflammation associated with a condition such as bursitis. In fact, it can be used to treat both acute and chronic joint pain.
- Boil 1 teaspoon of turmeric powder in 1 glass of milk. Add a little raw honey and drink it twice daily for at least a few days.
- Alternatively, take a curcumin supplement daily after consulting your doctor.
Acupuncture, a traditional Chinese form of treatment, is beneficial and effective for the relief of pain and inflammation associated with bursitis.
In acupuncture, a therapist uses thin needles to apply pressure on specific points to help ease the pain.
A 2017 study published in the Imperial Journal of Interdisciplinary Research (IJIR) found that acupuncture can effectively reduce pain and ease the stiffness in patients suffering from shoulder bursitis.(10)
Always get acupuncture done by an expert for optimal results.
10. Anti-inflammatory Foods
Given there are many foods that boast potent anti-inflammatory properties, what you eat can play a major role in reducing pain and inflammation in your body.(11)
Some of the anti-inflammatory foods and herbs that you can easily include in your diet are tart cherries, olive oil, sage, ginger, turmeric, green tea, salmon, cayenne pepper, cinnamon, cloves, garlic, and pineapple, to name a few. Customizing your diet to favor the intake of these anti-inflammatory foods can be a complementary tool in managing the symptoms of bursitis and in expediting the healing process
Moreover, it is well advised to cook with olive oil or coconut oil instead of margarine and vegetable oils in order to fight inflammation.
- Dimethyl sulfoxide (DMSO), derived from wood pulp, can also help in the treatment.
- Vitamin C is a wonder nutrient for the prevention and healing of joint injuries. Consume vitamin C-rich foods or take a supplement after consulting your doctor.
Expert Answers (Q&A)
Answered by Dr. Kevin W. Farmer (Orthopedic Surgeon)
How long does it take for bursitis to heal completely?
The time it takes to heal bursitis is variable. The amount of inflammation, level of activity, and treatments can all affect the time for healing. Typically, around 6 weeks of treatment should lead to full recovery.
For those that continue to inflame the area through certain activities, it may take longer to resolve the symptoms. In rare cases, surgery may be required to remove the inflamed bursa.
What foods facilitate easy recovery from bursitis?
Although there isn’t much research on the role of particular foods in the recovery from bursitis, a high-quality diet which is low in refined sugars is generally preferred. It is advisable to avoid highly processed foods as well.
Juven, a nutritional shake, has shown to improve the healing process following surgery and can be considered as a dietary aid in making a speedy recovery.
Is massage helpful for bursitis?
Massage can be helpful for the surrounding musculature, and as part of the rehab plan as a whole. Massaging the bursitis itself may lead to worsening inflammation and is not advised. Massage should focus on the major muscle groups involved in the range of motion of the concerned extremity.
Does turmeric help in healing bursitis?
There is evidence that turmeric may have anti-inflammatory properties. The effect is thought to be through the blockade of cytokines in the inflammatory pathway, including COX-2, the target of some non-steroidal anti-inflammatories.
The therapeutic benefits accorded to turmeric can be traced back to the anti-oxidant curcumin, which has shown considerable potential for healing a variety of conditions.
Some studies have even shown turmeric to be helpful in the treatment of osteoarthritis. Although there is limited evidence for its use in bursitis, its anti-inflammatory properties make turmeric a viable option in the treatment of bursitis.
One must bear in mind, however, that the curcumin content of turmeric is not that high, and the compound has low bio-availability. At the same time, taking high-doses of turmeric can have a blood-thinning effect, and should be used with caution by those currently on blood-thinners.
What complications can arise if bursitis is left untreated?
Chronic, untreated bursitis can lead to other joint problems. Failure to correct the inflammation can lead to gait changes with lower extremity bursitis, which may lead to other injuries.
In case the shoulder is affected, chronic bursitis can lead to loss of motion, or frozen shoulder, as the patient moves the shoulder less and less to avoid pain.
Please provide some additional tips or inputs regarding bursitis for our readers to keep in mind.
Many cases of bursitis are caused by certain activities or over-activities. It’s important when starting new activities, sports, or exercises to focus on proper form.
It is also important to progressively increase activities in a controlled manner. As overuse is the most common cause of bursitis, it is important to increase volume gradually and allow your body time to acclimate to the activity.
About Dr. Kevin W. Farmer, MD: Kevin is an Associate Professor in the Department of Orthopedic Surgery at The University of Florida. He is an internationally known shoulder and sports medicine specialist, and the Team Physician for the Florida Gators.
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/bursitis#tab-overview. Published September 28, 2018.
- Bursitis a common cause of painful hips, knees, heels, and elbows. American Academy of Orthopaedic Surgeons. https://www.eurekalert.org/pub_releases/2011-06/aaoo-bac060711.php. Published June 7, 2011.
- Williams CH. Bursitis. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK513340/. Published June 25, 2018.
- Ice Packs vs. Warm Compresses For Pain. Ice Packs vs. Warm Compresses For Pain – Health Encyclopedia – University of Rochester Medical Center. https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=85&contentid=p00918.
- Joon Yun Kim, Seok Won Chung, JooHak Kim, et al. A Randomized Trial Among Compression Plus Nonsteroidal Antiinflammatory Drugs, Aspiration, and Aspiration With Steroid Injection for Nonseptic Olecranon Bursitis. Clinical Orthopedics and Related Research. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4746156/.
- Johns Hopkins Medicine. https://www.hopkinsmedicine.org/healthlibrary/conditions/orthopaedic_disorders/bursitis_85,P00047.
- Young-Ran Yeun. The effectiveness of massage therapy for shoulder pain: a systematic review and meta-analysis. Journal of Physical Therapy Science. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462703/. Published 2017.
- Benzie, Wachtel-Galor S, Boca Raton. Chapter 7The Amazing and Mighty Ginger. Herbal Medicine: Biomolecular and Clinical Aspects. 2nd edition. https://www.ncbi.nlm.nih.gov/books/NBK92775/. Published 2011.
- Matthew C.Fadus, CeciliaLau, JaiBikhchandani, Henry T.Lynchc. Curcumin: An age-old anti-inflammatory and anti-neoplastic agent. Journal of Traditional and Complementary Medicine. https://www.sciencedirect.com/science/article/pii/S2225411016302528. Published 2017.
- Zhu J, Arsovska B, Nikolovska K. Shoulder Bursitis Treatment with Acupuncture. Imperial Journal of Interdisciplinary Research (IJIR). https://www.researchgate.net/publication/314104567. Published February 2017.
- Jane Hart, Cori Diekmeier. Diet and inflammation. Michigan State University. http://www.canr.msu.edu/news/diet_and_inflammation. Published 2014.