Bursitis

Overview

Bursitis is inflammation of a bursa. A bursa is a small sac filled with fluid. It sits between bone and the softer tissue around it, like a tiny cushion. Its job is to reduce friction, so tendons, muscles, and skin can glide smoothly over bone.

You have more than 150 bursae in your body. Any of them can become irritated, but some spots are more prone than others. The shoulder, hip, elbow, knee, and heel are the most common places. When a bursa is irritated, it makes extra fluid and swells. That swelling is what makes pressure and movement feel sore.

The good news: most bursitis settles. With a short period of relative rest, gentler use, and small changes to how you move, the area usually calms down over days to weeks.

Common Experiences

Bursitis feels different depending on where it shows up. People often report:

• An aching or tender spot close to a joint, rather than deep inside it
• Pain when pressing on the area, for example lying on one hip in bed
• Pain that grows with repeated movement, such as reaching, kneeling, or climbing stairs
• Stiffness that eases a little once you warm up and get moving
• Visible swelling near the elbow or kneecap, sometimes like a small soft ball under the skin
• Shoulder pain when lifting the arm out to the side or reaching overhead
• Outer hip pain that flares after long walks or long sitting

Many people notice the pain is worst at night or first thing in the morning. This is common with hip and shoulder bursitis, because lying still puts steady pressure on the sore spot.

Why It May Develop

A bursa becomes irritated when it gets more pressure or friction than it can handle. Common reasons:

Repeated pressure. Kneeling for hours while gardening, cleaning, or laying floors can irritate the bursa in front of the kneecap. Leaning on the elbows at a desk can do the same at the elbow.

Repetitive motion. The same movement, done many times, rubs the same spot. Painting a ceiling, throwing, or swimming can irritate the shoulder bursa.

A sudden jump in activity. Starting a new walking or running routine too quickly is a classic trigger for outer hip pain.

Movement habits. When one area is stiff, nearby tissue does extra work. If the hip joint or lower spine moves less, the tissue on the outer hip may take more friction with every step. This is one reason hip stiffness and bursitis often appear together.

Age. Tendons and bursae tolerate load a little less well over time, so bursitis becomes more common in midlife and beyond.

Other health conditions. Rheumatoid arthritis, gout, and diabetes can make bursitis more likely.

Infection. In a small number of cases, bacteria enter the bursa, often through a break in the skin near the elbow or knee. This form needs prompt medical care.

Conventional Support Options

Clinicians usually start with simple, conservative steps:

• Relative rest. Ease off the activity that stirs it up, without stopping all movement.
• Pressure relief. Cushions for kneeling, a change of sleeping side, or not leaning on the sore elbow.
• Ice. Short sessions in the first days can ease soreness and swelling.
• Medicines that calm inflammation. A clinician or pharmacist can advise on options such as ibuprofen.
• Physical therapy. A physical therapist may work on strength, movement habits, and how the joint is loaded.
• Draining the fluid. A clinician may remove extra fluid with a needle, and test it if infection is a question.
• Corticosteroid injection. Sometimes offered for stubborn cases, most often at the hip or shoulder.
• Surgery. Rare, and usually only after other options have been tried.

If the bursa is infected, antibiotics are needed, and care should not be delayed.

What the Research Suggests

Bursitis has not been studied as heavily as conditions like osteoarthritis, but the overall picture is consistent:

• Clinical references such as StatPearls describe conservative care as the usual path. Most cases settle with rest, pressure relief, and a gradual return to activity. Surgery is a rare last step.
• Because friction and load are central to the problem, how you move matters. Changing the pattern that irritates the bursa is a core part of most care plans.
• A 2022 systematic review and meta analysis of 16 randomized controlled trials looked at the Feldenkrais Method across different groups. It reported improvements in pain and functional balance in people with neck, upper back, or shoulder pain, and better gait, balance, and mobility in older adults. The review did not study bursitis directly. Still, it supports the idea that learning gentler movement patterns is associated with less pain in loaded, sensitive areas.

Movement & Mobility Considerations

The key question with bursitis is not "how do I stop moving?" but "how can I move with less friction on this one spot?"

This is where movement awareness fits. The Feldenkrais Method® approaches this by exploring alternative ways to move, slowly and with attention. Awareness Through Movement® lessons are done lying down or sitting, with small, light movements, so a sore bursa is not pressed or forced. If the outer hip is sore, for example, a lesson might explore how the pelvis, ribs, and spine share the work of walking, so each step loads the hip more evenly.

A few practical ideas:

• Keep moving, gently. Long stillness lets the area stiffen, while overload keeps it irritated. Aim for the comfortable middle.
• Lower the effort. Many people brace around a sore spot. That extra muscle tension adds compression and friction. Noticing the bracing, and letting some of it go, can make everyday movement feel lighter.
• Spread the work. If one joint or one side is doing everything, nearby areas can share the load. Small changes in how you stand, walk, or reach add up over a day.
• Vary your positions. Change how you sit, sleep, and lean so the same spot is not under pressure for hours.

Movement awareness work is not a replacement for clinical care. It sits alongside the steps your clinician suggests, such as pressure relief or physical therapy. Practices like yoga, Pilates, and tai chi work through a different mechanism. They build flexibility, strength, and balance through poses and flowing sequences, and many people return to them with small adjustments once the sore spot has calmed down.

When to Seek Professional Care

Most bursitis can be looked after at home at first, but some signs need urgent attention. Seek medical care promptly if:

• The skin over the joint is red, hot, and swollen, or feels feverish to the touch
• You have a fever, chills, or feel generally unwell
• The pain is severe or getting worse quickly

These signs can point to septic bursitis, which is an infection inside the bursa. It needs prompt medical care, usually with antibiotics, so do not wait it out.

Also make an appointment if:

• Pain has not improved after one to two weeks of sensible self care
• The same bursa flares again and again
• The swelling is large or keeps growing
• You cannot move the joint through its usual range, or cannot put weight on the leg
• You are not sure what is causing the pain. Other issues, like joint changes or a tendon problem, can feel similar, and a clinician can identify what is going on.

Related Topics

• Hip bursitis exercises: gentle ways to keep the hip moving while a bursa settles
• Exercises to avoid with hip bursitis: common movements that keep the outer hip irritated
• The Feldenkrais Method: how movement awareness lessons work
• Osteoarthritis and joint discomfort: joint changes that often appear alongside bursitis
• Hip stiffness and limited mobility: stiffness patterns that add friction at the outer hip
• Frozen shoulder: another common cause of shoulder pain and stiffness

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Feldenkrais Method®, Awareness Through Movement®, and Functional Integration® are registered service marks of the Feldenkrais Guild® of North America.