Bursitis
Also called: inflamed bursa, shoulder bursitis, hip bursitis, knee bursitis, elbow bursitis. Clinical name: Bursitis (subacromial, olecranon, trochanteric, prepatellar and others).
Most bursitis settles in 2–6 weeks once the pressure or overload causing it stops. A bursa that turns hot, red and increasingly painful may be infected and needs same-day medical care.
What it actually is
A bursa is a small, fluid-filled cushion, the body has more than a hundred of them, sitting wherever tendon, bone and skin need to slide past each other without friction. Bursitis is one of those cushions inflamed, and it happens at predictable addresses: the shoulder under the point of the bone, the tip of the elbow, the outside of the hip, the front of the kneecap, the heel. The cause is usually monotonous: repeated pressure or repeated load, kneeling floors, leaning on desks, overhead work, a running spike.
The experience is a localised, position-specific ache with tenderness right over the spot, sometimes with a visible soft swelling, and the treatment for the common irritative kind is almost disappointingly simple: remove the pressure or trim the load, keep the joint gently moving, and let two to six weeks pass. At the shoulder and hip there is a twist worth knowing, the bursa is usually the smoke, and an overloaded tendon next door is the fire, so lasting relief there tends to come from strengthening rather than resting.
One version of this condition breaks the calm-and-wait rule entirely. When a bursa near the surface, elbow tip and kneecap especially, turns hot, red and angrier by the day, it may be infected, and septic bursitis is a same-day medical problem. That is the single most useful thing to watch for day to day, and a two-line daily note of swelling, warmth and what pressed on it is both the early-warning system and the exact history a clinician will want.
How bad is it?
Bursitis is not graded; what matters is the cause and the joint. Most cases are irritative: a bursa, one of the small fluid cushions that sit between tendon, bone and skin, inflamed by repetitive pressure or overload, think kneeling floors, leaning on elbows, overhead work, or a spike in running for the hip. These settle with load management over weeks. The one to take seriously is septic bursitis, an infected bursa, most common at the elbow and kneecap where the bursa sits just under the skin: the area becomes hot, red and increasingly painful, sometimes with fever, and it needs same-day medical care, not ice and patience.
How long will it take?
Recovery moves in phases. This is the typical shape of it — yours may run faster or slower, and the numbers below are general ranges, not a forecast for your specific injury.
When to get it looked at
Most cases settle with time and sensible loading. Get it assessed by a professional if any of these apply — they can point to something that needs hands-on care:
- A bursa area that is hot, red and increasingly painful (possible infection, seek same-day care)
- Fever or feeling unwell alongside a swollen bursa
- A wound, graze or puncture over the swollen area
- Rapidly increasing swelling, or severe pain at rest
- Bursitis in multiple joints at once, or alongside unexplained weight loss (worth a broader medical review)
This is a list of warning signs, not a diagnosis. If you are worried, or the pain is severe, see a GP, physiotherapist or urgent care.
What to track while you recover
Bursitis is a pressure-and-load story, and the pattern between what you did and how it swelled is the diagnosis. A short daily note also catches the one dangerous turn, towards heat and redness, early.
- Pain score, 0–10, at rest and on the provoking movement or pressure
- Visible swelling: bigger, same or smaller than yesterday
- Any warmth or redness over the area (check daily, this is the infection watch)
- What pressed on it or loaded it today: kneeling, leaning, overhead work, hills
- What you changed: padding, activity modification, ice, and what difference it made
This is exactly what InjuryLog does.
Log each of these in seconds, watch the trend build day by day, and keep every scan and receipt tied to this one injury. Free on iOS, Android soon.
Wondering how long yours will take? Try the free recovery time estimator for a typical, phased timeline by injury and severity.
What to tell your physio
The consult moves fast when the pattern is on paper: which positions provoke it, how the swelling has trended, and whether there has been any heat or redness.
- Where it is and what it stops you doing: lying on that hip, kneeling, reaching overhead
- What repetitive pressure or activity preceded it, work and sport included
- The swelling trend since it started, and any episodes of warmth or redness
- Whether it has happened before in the same spot and what helped last time
- For shoulder and hip: what strengthening you have tried, since the tendon next door is usually part of the story
Walk in with the whole picture.
InjuryLog turns your daily logs into a clean Physio Visit Pack, a one-page summary your physio can actually read, so the first appointment starts with facts, not guesswork.
The questions people actually ask
How long does bursitis take to heal?
Most straightforward bursitis improves within a couple of weeks of removing the cause and settles fully over two to six weeks. Hip and shoulder bursitis can run longer, one to two months is not unusual, because they usually travel with tendon overload that needs rebuilding, not just resting. The cases that drag are almost always the ones where the provoking pressure or activity never actually stopped, or where an underlying strength issue was never addressed.
What does bursitis feel like?
A localised ache and tenderness over one spot, worse with pressure on it or movement of the nearby joint, and sometimes a visible soft swelling, most striking at the elbow tip or kneecap, where the bursa can inflate like a small cushion. Shoulder bursitis hurts reaching overhead and lying on that side; hip (trochanteric) bursitis hurts lying on that hip and climbing stairs. The skin normally looks calm, which is the important contrast with an infected bursa, where heat and redness join in.
How do I know if my bursitis is infected?
Watch the skin, the temperature and the trajectory. An infected (septic) bursa becomes hot, red and increasingly painful, the swelling grows rather than shrinks, and you may feel feverish or unwell. It is most common at the elbow and kneecap, where the bursa sits just under the skin and a graze can let bacteria in. This is a same-day medical assessment, because an infected bursa may need antibiotics and drainage, and it does not fix itself with ice and patience.
Should I drain the fluid or get an injection?
Usually neither, at first. Most bursitis settles once the cause stops, and draining a sterile bursa often sees it simply refill. Aspiration earns its place when infection is suspected (the fluid itself is the diagnostic test) or when swelling is large and limiting. A corticosteroid injection can quiet a stubbornly inflamed bursa, particularly at the shoulder or hip, though for those areas the lasting fix is usually a strengthening programme for the tendons alongside, with the injection buying a comfortable window in which to do it.
Can I exercise with bursitis?
Yes, with the aggravator removed. Total rest is rarely required and often unhelpful; joints stiffen and the tendons alongside weaken. The rule is to keep moving in the ranges and activities that do not provoke the bursa while strictly avoiding the specific pressure or movement that does: pad the knee if you must kneel, stop leaning on the elbow, swap overhead sessions for something neutral for a few weeks. For hip and shoulder bursitis, graded strengthening is actively part of the treatment rather than a risk to it.
Why does my bursitis keep coming back?
Recurring bursitis nearly always means the driver is still there. At the knee and elbow that is usually occupational pressure, kneeling trades and desk-leaning respectively, and the fix is padding and habit change more than medicine. At the shoulder and hip, recurrence usually means the underlying tendon overload was never rehabilitated: the bursa calmed down, the weak tendon kept getting overloaded, and the alarm went off again. A tracked history of what preceded each flare is exactly how you and a clinician find the pattern.
Sources
- Bursitis — NHS
- Hip Bursitis — AAOS OrthoInfo