Bursitis is a condition that causes inflammation of the bursae, which are small fluid-filled sacs that cushion bones, tendons, and muscles near joints. It can lead to pain, swelling, and limited mobility. However, bursitis is most often a secondary issue—meaning that something else is causing irritation to the bursa, which then leads to inflammation. To truly treat bursitis effectively, the root cause must be identified and addressed rather than just managing inflammation.
Anatomy & Function of the Bursa:
Bursae are found throughout the body, especially near major joints like the shoulder, elbow, hip, knee, and ankle. Each bursa is lined with a synovial membrane that secretes synovial fluid, reducing friction and allowing smooth movement between bones, tendons, and muscles.
Functions of the bursae include:
- Reducing friction between moving structures.
- Absorbing shock and distributing pressure.
- Protecting joints from mechanical stress and overuse injuries.
Picture showing the anatomy of the shoulder bursa: Shoulder Sub-acromial bursa
Bursitis: A Secondary Condition
Bursitis itself is not the primary problem in most cases—it develops because of an underlying mechanical issue, repetitive strain, poor biomechanics, or another contributing factor. Simply treating the inflamed bursa without addressing what caused the irritation in the first place will often lead to recurrence.
Common underlying causes include:
- Muscle imbalances (tight or weak muscles altering movement patterns)
- Repetitive overuse movements (e.g., running, kneeling, throwing, lifting)
- Poor posture or biomechanics (leading to excessive joint stress)
- Joint instability or misalignment
- Tendon or ligament dysfunction nearby
- Arthritic changes in the joint
Identifying and correcting the root issue is essential to resolving bursitis long-term.
Types of Bursitis:
Depending on which bursa is affected, bursitis can occur in different locations:
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- Shoulder (Subacromial Bursitis): Irritation caused by impingement or rotator cuff dysfunction.
- Elbow (Olecranon Bursitis): Often caused by direct pressure or repetitive stress.
- Hip (Trochanteric Bursitis): Commonly linked to gluteal weakness or gait abnormalities.
- Knee (Prepatellar & Infrapatellar Bursitis): Often due to kneeling or improper squat mechanics.
- Heel (Retrocalcaneal Bursitis): Associated with tight calves or improper footwear.
Symptoms of Bursitis:
The signs and symptoms of bursitis can vary depending on the location of the affected bursa, but the most common symptoms include:
- Pain, often worsening with movement or pressure.
- Swelling around the affected joint.
- Tenderness and warmth over the bursa.
- Stiffness and reduced range of motion.
- Difficulty with activities that involve the affected joint.
What Causes Bursitis?:
Since bursitis is usually secondary to another issue, some common contributing factors include:
- Repetitive movements or overuse (e.g., athletes, manual laborers, musicians)
- Poor movement mechanics or posture (causing excessive joint strain)
- Muscle tightness or weakness (affecting joint function and loading)
- Direct trauma or prolonged pressure on the joint
- Inflammatory conditions (rheumatoid arthritis, gout, diabetes)
- Bacterial infection (septic bursitis)
Treating Bursitis: Addressing the Root Cause
While bursitis cannot always be prevented, there are some steps you can take to reduce your risk of developing this condition:-
Since bursitis is often a symptom of a bigger problem, treatment should go beyond short-term inflammation management. While initial care focuses on reducing pain and inflammation, long-term resolution requires identifying and correcting the underlying cause.
Initial Symptom Management:
- RICE (Rest, Ice, Compression, Elevation) to reduce swelling.
- Pain relief medication (NSAIDs or acetaminophen).
- Activity modification to avoid aggravating movements.
Long-Term Treatment & Prevention:
- Soft Tissue Occupational Therapy:
- Identifies and corrects movement dysfunctions contributing to bursitis.
- Uses hands-on techniques to reduce soft tissue restrictions.
- Provides exercises to strengthen supporting muscles and improve biomechanics.
- Progressive loading & strength training to prevent excessive stress on the bursa.
- Postural correction & movement retraining to optimize joint function.
- Orthotics or proper footwear to correct gait abnormalities.
- Shockwave therapy or dry needling (when appropriate) to assist tissue healing.
Preventing Bursitis Recurrence:
To minimize the risk of bursitis returning, consider:
- Improving movement mechanics through strength and mobility training.
- Avoiding excessive repetitive movements without proper recovery.
- Wearing supportive footwear and using ergonomic tools if needed.
- Maintaining a balanced exercise routine that includes flexibility and strengthening.
Key Takeaway:
Bursitis is not just about inflammation—it’s a secondary condition caused by an underlying mechanical or functional issue. To fix bursitis for good, you need to find and correct the root cause, whether it’s a movement dysfunction, muscle imbalance, or poor biomechanics. Seeking treatment from a Soft Tissue Occupational Therapist can help address these issues and prevent recurrence.