Understanding Bursitis: Hip, Knee, and Shoulder Explained

Bursitis is the inflammation of a small, fluid-filled sac called a bursa. These sacs act as cushions between bones, tendons, and muscles to reduce friction and aid smooth movement. When a bursa becomes inflamed, it can lead to pain, swelling, and restricted movement in the affected area.

Bursitis most commonly affects the hip, knee, and shoulder—joints that are under constant use. It may arise from repetitive motion, direct trauma, poor posture, or underlying conditions like arthritis. Prompt recognition and treatment can help prevent chronic discomfort and mobility issues.

Hip Bursitis (Trochanteric Bursitis)

Trochanteric bursitis occurs when the bursa over the greater trochanter (the bony point on the side of the hip) becomes inflamed. It is particularly common in runners, individuals with leg length discrepancies, or those with gluteal weakness.

Typical symptoms include:

• Outer hip pain that worsens when lying on the affected side

• Tenderness when pressing over the hip

• Discomfort during walking, climbing stairs, or prolonged standing

What to do:
Treatment involves activity modification, physiotherapy to strengthen the gluteal muscles, and anti-inflammatory strategies. Shockwave therapy or regenerative injections such as PRP may help resolve chronic cases.

Knee Bursitis (Prepatellar or Pes Anserine Bursitis)

Knee bursitis typically affects the prepatellar bursa (in front of the kneecap) or the pes anserine bursa (on the inner lower side of the knee). It often arises from prolonged kneeling, overuse, or sports involving repetitive stress.

Common signs include:

• Swelling over the kneecap or inner knee

• Warmth and tenderness to touch

• Pain with kneeling or bending

What to do:
Initial treatment includes rest, ice, and compression. Physiotherapy addresses biomechanical imbalances, while aspiration or corticosteroid injections may be required in more severe cases.

Shoulder Bursitis (Subacromial Bursitis)

Subacromial bursitis occurs when the bursa beneath the acromion (the bony top of the shoulder) becomes inflamed. It frequently coexists with rotator cuff irritation or impingement and is common in overhead athletes or manual workers.

Symptoms often include:

• Pain on lifting the arm sideways or overhead

• Night pain, especially when lying on the affected side

• Limited shoulder mobility

What to do:
Activity modification, rotator cuff strengthening, and posture correction are first-line treatments. Ultrasound-guided injections can reduce inflammation, and long-standing cases may benefit from imaging to rule out tendon damage.

Long-Term Impacts of Bursitis if Left Untreated

Untreated bursitis can lead to persistent inflammation, thickening of the bursa, and eventual restriction in joint function. It may also mask underlying issues such as tendon tears, joint degeneration, or instability.

Chronic bursitis can limit daily activities, disrupt sleep, and even lead to compensatory pain in other joints due to altered movement patterns.

Treating and Preventing Bursitis

Early and comprehensive management can often resolve bursitis without invasive intervention. Addressing the root causes, such as muscular imbalance, poor biomechanics, or repetitive strain, is essential for long-term recovery.

Recommended strategies include:

• Activity modification to reduce repetitive irritation

• Targeted rehabilitation to restore balance and strength

• Anti-inflammatory treatments, both pharmacological and physical (ice, cryo-ultrasound)

• Shockwave therapy or PRP for resistant cases

• MAI-Motion™ assessment to identify and correct movement asymmetries

Preventative measures such as cross-training, ergonomic awareness, and regular strength training can significantly reduce recurrence risk.

Frequently Asked Questions (FAQs)

What causes bursitis to flare up?
Common triggers include repetitive motion, prolonged pressure (e.g. kneeling), poor posture, or sudden injury. Underlying arthritis or infection may also contribute.

Is bursitis the same as arthritis?
No—bursitis is inflammation of a bursa, while arthritis affects the joint itself. However, both can coexist and cause joint pain.

Can bursitis go away on its own?
Mild bursitis may resolve with rest and conservative care. Persistent cases require physiotherapy or medical treatment to prevent chronic inflammation.

Should I exercise with bursitis?
Gentle movement and guided physiotherapy can help. Avoid activities that directly aggravate the bursa until symptoms subside.

When should I see a doctor for bursitis?
If pain persists for more than a few days, restricts movement, or causes swelling and redness, medical evaluation is recommended to rule out infection or deeper joint problems.

Are injections safe for bursitis?
Yes. Corticosteroid or PRP injections can effectively reduce inflammation in severe cases. These should be administered under guidance and monitored by a specialist.