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Bursitis by Stephen Coleman

Bursitis is the inflammation or swelling and irritation of a structure in the body known as a bursa.
A bursa is essentially a fluid filled sac that usually lies between bone and soft tissues that are usually
adjacent to other soft tissues.

The purpose of the Bursa is to reduce friction usually between bone and the soft tissues such as muscles and tendons that are adjacent to it. Most of the larger joints of the body have several Bursa, big and small. For example, the knee has a total of 11 Bursa.

Burisitis occurs for several reasons and can be quite a painful condition. These can include:

  • Trauma – direct impact or injury to the area can cause inflammation to a bursa.
  • Sustained pressure – applied to the area containing the bursa can also cause it to become inflamed, this might be leaning on the elbow while working at a desk or working on the knees.

  • Repetitive movement – repeatedly loading the area in a similar way, using the same muscles and tissues may irritate the underlying bursa. A baseball player throwing a ball for example.


  • Infectious bursitis – otherwise known as septic bursitis. In this case the infection from bacteria causes the inflammation and this would require anti-biotics.


  • Secondary to other diseases – such as gout and rheumatoid arthritis and some thyroid dysfunctions.

Typically bursitis will cause pain and swelling in the affected area and the use of the surrounding
muscles and soft tissues may also be painful.

If it is a superficial bursa near the surface of the skin it may also appear red and hot. It may limit range of motion due to pain mostly.

Bursitis can also commonly occur in conjunction with tendinitis,
though it is important to rule out any other differential diagnoses.

Initially treating the condition with rest in the form of optimal loading, ice and anti-inflammatories may be recommended.
Further treatments as pain settles would include exercise prescription to help support the affected area and lengthen surrounding tissues as well as encourage helpful movement patterns.

In some cases massage and manual treatment of surrounding structures can also help to offload the affected area. Steroidal injections can also be considered. The treatment of infectious bursitis usually requires more medical treatment.

by Stephen Coleman, Chartered Physiotherapist

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