Diagnosing the 4 Most Common Types of Bursitis

Bursitis is a common condition that occurs when the bursa becomes inflamed and irritated. There are several types of bursitis, and they can be treated and prevented, usually with conservative measures.

You have hundreds of bursae scattered throughout your body. These connective tissue structures help promote smooth motion between bones, tendons, and muscles. When the bursa becomes inflamed, simple movements can become painful.


Shoulder Bursitis

Woman with shoulder pain

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Shoulder bursitis is a common cause of shoulder pain. The shoulder bursa helps your rotator cuff, which is a muscle that lies on top of your shoulder, glide smoothly beneath the acromion bone. When the shoulder bursa is inflamed, subacromial bursitis, also called shoulder bursitis or rotator cuff tendonitis, develops.

This condition usually improves with conservative treatment, such as rest or ice.

Sometimes, however, subacromial decompression is necessary. During this procedure, the bursa is removed to relieve inflammation. This surgery is typically done in conjunction with other procedures to address the underlying cause of bursitis at the same time.


Hip Bursitis (Trochanteric Bursitis)

Hip pain
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Hip bursitis causes pain on the outside of the hip joint. It can feel like hip arthritis, but the pain of hip bursitis is consistently felt on the outside of the hip, whereas pain from hip arthritis is typically felt in the groin, thigh, or buttocks. 

Hip bursitis most often hurts with direct pressure on the hip, such as when you sleep on your side at night. Hip bursitis will almost always improve with conservative treatments—including rest, ice, injections, and physical therapy.


Elbow Bursitis (Olecranon Bursitis)

Elbow bursitis

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Elbow bursitis, also called olecranon bursitis, occurs due to pain and swelling of the bursa on the back of the elbow joint. The olecranon is the bony prominence on the back of the elbow. This is the upper part of the ulna bone, and the olecranon bursa sits just between the skin and the bone. 

The olecranon bursa is susceptible to infection due to contamination from scrapes, cuts, or an injection into the bursa. These injuries can lead to a bacterial infection. While minor infections can resolve with nonsurgical treatment, an infected olecranon bursa may require surgical treatment.


Kneecap Bursitis (Prepatellar Bursitis)

Woman with knee pain

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Kneecap bursitis occurs when there is pain and swelling on the front of the knee joint, directly on top of the patella (kneecap).  Kneecap bursitis is also called prepatellar bursitis.

Prepatellar bursitis can be distinguished from other causes of knee swelling by an examination of the joint to determine if the swelling is in front of the knee or inside the joint.

Kneecap bursitis develops when people spend time kneeling. This often affects workers, such as roofers or flooring workers.  It can also result from activities around the house, such as floor cleaning, gardening, or even playing with little kids.

One of the best ways to prevent kneecap bursitis is to wear knee pads to cushion the prepatellar bursa during kneeling activities.


Treatment of Bursitis

knee pads
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Bursitis treatment depends on the type of bursitis, as there are subtle differences in the treatment of each type. 

However, there are some general themes in treatment:

  • Rest the inflamed bursa
  • Help the inflammation to subside
  • Prevent the condition from becoming persistent or recurrent

Some of the most common treatments for managing bursitis include applying ice, taking oral anti-inflammatory medications, and getting cortisone injections—depending on the specific type of bursitis involved. All of these treatments are aimed at controlling the inflammation of the affected area.

In addition, physical therapy can be an essential aspect of treatment. Even for physically active people, specifically tailored exercises to improve joint mechanics to restore normal alignment and joint function can help to alleviate the symptoms of bursitis and prevent recurrence.

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By Jonathan Cluett, MD
Jonathan Cluett, MD, is board-certified in orthopedic surgery. He served as assistant team physician to Chivas USA (Major League Soccer) and the United States men's and women's national soccer teams.