Bursitis is a common condition causing pain and inflammation around joints, affecting millions of people each year. Understanding the different types of bursitis and their treatment options can help you recover faster and prevent recurrence. At M.O. Therapy in Markham, we provide comprehensive treatment for bursitis affecting the hip, shoulder, knee, and other areas.
Understanding Bursitis
What Is a Bursa?
Bursae are small, fluid-filled sacs found throughout the body that reduce friction between tissues:
- Located between bones, tendons, and muscles
- Contain synovial fluid for lubrication
- Allow smooth movement of tissues
- Over 150 bursae in the body
What Is Bursitis?
Bursitis occurs when a bursa becomes inflamed:
- Bursa fills with excess fluid
- Causes pain, swelling, and tenderness
- May limit joint movement
- Can be acute or chronic
Causes of Bursitis
Repetitive Motion:
- Overuse of joint
- Repetitive activities
- Occupational movements
- Sports activities
Direct Trauma:
- Fall onto joint
- Direct blow
- Kneeling on hard surfaces
- Leaning on elbows
Underlying Conditions:
- Rheumatoid arthritis
- Gout
- Diabetes
- Thyroid conditions
Infection (Septic Bursitis):
- Bacteria enter bursa
- Usually through skin break
- Requires medical attention
- May need antibiotics
Hip Bursitis
Types of Hip Bursitis
Trochanteric Bursitis (Greater Trochanteric Pain Syndrome):
- Most common type
- Located on outer hip
- Over the bony prominence (greater trochanter)
- Often associated with gluteal tendinopathy
Iliopsoas Bursitis:
- Front of hip/groin area
- Between iliopsoas muscle and hip joint
- Often associated with hip flexor tightness
- Can mimic other hip conditions
Ischial Bursitis (Weaver's Bottom):
- Over sit bones
- Pain with sitting
- Common in those who sit frequently
- Can be chronic
Hip Bursitis Symptoms
- Pain on outer hip (trochanteric)
- Pain worse when lying on affected side
- Pain with walking, stairs, or getting up
- Tenderness over bony prominence
- May radiate down outer thigh
- Worse with prolonged activity
Hip Bursitis Treatment
Activity Modification:
- Avoid lying on affected side
- Reduce aggravating activities
- Use pillow between knees when sleeping
- Avoid repetitive hip movements
Exercise Therapy:
- Hip strengthening (especially gluteus medius)
- Stretching (IT band, hip flexors)
- Core stability exercises
- Progressive loading program
Manual Therapy:
- Soft tissue mobilization
- IT band release
- Hip joint mobilization
- Dry needling
Other Treatments:
- Ice for acute inflammation
- Corticosteroid injection (if conservative treatment fails)
- Shockwave therapy (chronic cases)
Shoulder Bursitis
Types of Shoulder Bursitis
Subacromial Bursitis:
- Most common type
- Between rotator cuff and acromion
- Often associated with rotator cuff problems
- Part of impingement syndrome
Subdeltoid Bursitis:
- Continuous with subacromial bursa
- Under deltoid muscle
- Similar presentation to subacromial
Shoulder Bursitis Symptoms
- Pain on top or front of shoulder
- Pain with overhead activities
- Night pain (lying on shoulder)
- Difficulty reaching behind back
- Pain with reaching across body
- May have weakness
Shoulder Bursitis Treatment
Activity Modification:
- Avoid overhead activities temporarily
- Modify sleeping position
- Reduce aggravating movements
- Use arm within pain-free range
Exercise Therapy:
- Rotator cuff strengthening
- Scapular stability exercises
- Postural correction
- Range of motion exercises
Manual Therapy:
- Soft tissue mobilization
- Joint mobilization
- Trigger point release
- Dry needling
Other Treatments:
- Ice for acute inflammation
- Corticosteroid injection
- Consider imaging if not improving
Knee Bursitis
Types of Knee Bursitis
Prepatellar Bursitis (Housemaid's Knee):
- Front of kneecap
- Common with kneeling
- Often swelling visible
- May become chronic
Infrapatellar Bursitis (Clergyman's Knee):
- Below kneecap
- Over patellar tendon
- Less common than prepatellar
- Similar causes
Pes Anserine Bursitis:
- Inner knee below joint line
- Common in runners
- Associated with hamstring tightness
- May occur with knee arthritis
Baker's Cyst (Popliteal):
- Back of knee
- Often secondary to knee problems
- Can cause fullness or tightness
- May rupture
Knee Bursitis Symptoms
Prepatellar:
- Swelling over kneecap
- Pain with kneeling
- Warmth and redness (acute)
- Limited knee bending
Pes Anserine:
- Pain on inner knee
- Below joint line
- Worse with stairs
- Tender to touch
Baker's Cyst:
- Fullness behind knee
- Tightness with bending
- May feel like fluid
- Can cause calf pain if ruptures
Knee Bursitis Treatment
Prepatellar:
- Avoid kneeling
- Use knee pads if kneeling necessary
- Ice for swelling
- Compression wrap
- May need aspiration if significant swelling
Pes Anserine:
- Ice after activity
- Hamstring stretching
- Hip strengthening
- Address running mechanics if applicable
Baker's Cyst:
- Treat underlying knee condition
- May resolve spontaneously
- Aspiration rarely helpful long-term
- Surgery rarely needed
Other Common Bursitis Locations
Elbow (Olecranon) Bursitis
Causes:
- Leaning on elbows
- Direct trauma
- Infection (common site)
Treatment:
- Avoid leaning on elbows
- Elbow pad protection
- Ice for acute cases
- Monitor for infection signs
Heel (Retrocalcaneal) Bursitis
Causes:
- Tight shoes
- Haglund's deformity
- Associated with Achilles issues
Treatment:
- Footwear modification
- Heel lift
- Ice
- Stretching
General Treatment Principles
Conservative Treatment First
RICE Protocol (Acute):
- Rest from aggravating activities
- Ice for 15-20 minutes
- Compression if swelling
- Elevation when possible
Activity Modification:
- Identify and avoid triggers
- Temporary activity reduction
- Use padding/protection
- Ergonomic modifications
Exercise and Strengthening
Goals:
- Strengthen surrounding muscles
- Improve joint mechanics
- Reduce load on bursa
- Prevent recurrence
General Program:
- Strengthen muscles around affected joint
- Improve flexibility of tight structures
- Address biomechanical issues
- Progress gradually
When to Consider Injection
Indications:
- Failure of conservative treatment (4-6 weeks)
- Significant pain limiting function
- Need for faster recovery
- Chronic cases
Important Notes:
- Not first-line treatment
- Effects may be temporary
- Shouldn't replace exercise therapy
- Limited number recommended
Red Flags - When to Seek Immediate Care
Seek medical attention for:
- Fever with joint swelling
- Red, hot, swollen joint
- Signs of infection
- Unable to move joint
- Rapidly worsening symptoms
- Open wound near bursa
Prevention Strategies
General Prevention
- Warm up before activity
- Use proper technique
- Take breaks during repetitive tasks
- Use protective equipment (knee pads, etc.)
- Maintain strength and flexibility
- Address problems early
Joint-Specific Prevention
Hip:
- Strengthen gluteal muscles
- Stretch hip flexors and IT band
- Avoid prolonged standing on one leg
- Use cushioning when sleeping on side
Shoulder:
- Maintain rotator cuff strength
- Address posture issues
- Avoid prolonged overhead activities
- Strengthen scapular muscles
Knee:
- Use knee pads when kneeling
- Strengthen quadriceps and hamstrings
- Maintain healthy weight
- Proper footwear
Frequently Asked Questions
How long does bursitis take to heal? Acute bursitis often improves within 2-4 weeks with proper treatment. Chronic bursitis may take 6-12 weeks or longer. Addressing underlying causes is important for long-term resolution.
Should I rest completely with bursitis? Complete rest isn't usually necessary or beneficial. Modified activity that avoids aggravating movements while maintaining some movement is typically recommended.
Can bursitis come back? Yes, bursitis can recur if underlying causes aren't addressed. Prevention strategies including strengthening, proper technique, and avoiding aggravating activities help reduce recurrence.
When should I get an injection for bursitis? Injections are typically considered after 4-6 weeks of conservative treatment without adequate improvement. They shouldn't be the first treatment option.
Book Your Assessment
If you're dealing with bursitis in the hip, shoulder, knee, or other area, M.O. Therapy in Markham can help. Our team will identify contributing factors and develop an effective treatment plan.
Call (905) 201-5827 or book online for your assessment. We offer direct billing and same-day appointments.