Bursitis: Symptoms, Causes, and Practical Relief in the UK

Bursitis occurs when a bursa—a small, fluid-filled sac that acts as a cushion between bones and soft tissues like muscles, tendons, or skin—becomes inflamed. The human body contains over 150 bursae, located near major joints. Their primary role is to reduce friction and allow for smooth movement.

When a bursa is irritated through repetitive movement, pressure, or a sudden impact, it fills with excess fluid. This leads to swelling and pain, often making it uncomfortable to move the affected limb. While it can occur in any joint, it is most frequently diagnosed in the shoulder (subacromial bursitis), elbow (olecranon bursitis), hip (trochanteric bursitis), and knee (prepatellar bursitis or 'housemaid's knee').

The symptoms of bursitis typically develop gradually, though they can appear suddenly if caused by a direct injury. In the UK, many people mistake bursitis for simple muscle strain or arthritis. Common indicators include:

• Joint Pain: An achy or stiff sensation in the joint, which often worsens during movement or when pressure is applied (such as kneeling or leaning on an elbow).
• Visible Swelling: The area may look larger than usual or have a soft, fluid-filled lump. This is particularly noticeable at the elbow or knee.
• Redness and Warmth: The skin over the bursa may appear red and feel warm to the touch.
• Reduced Range of Motion: Difficulty performing everyday tasks, such as reaching for a high shelf or walking up stairs.

It is important to monitor these symptoms closely. If the swelling is accompanied by a high temperature or the skin feels very hot, it could indicate an infected bursa, known as septic bursitis.

Bursitis is frequently an overuse injury, making it common among individuals with physically demanding jobs or those who engage in specific sports. Key causes include:

• Repetitive Strain: Frequent movements like throwing a ball, lifting heavy items, or repetitive gardening tasks can irritate the bursa over time.
• Prolonged Pressure: Activities that require kneeling for long periods (like carpet fitting or gardening) or leaning on elbows can trigger inflammation.
• Traumatic Injury: A fall or a direct blow to a joint can cause a bursa to fill with blood or fluid suddenly.
• Inflammatory Conditions: People with rheumatoid arthritis, gout, or pseudogout are at a higher risk of developing bursitis.
• Infection: A cut or graze near a bursa can allow bacteria to enter, leading to septic bursitis.

Following UK clinical guidance, most cases of non-septic bursitis will improve with conservative 'self-care' within a few weeks. The 'PRICE' method is often recommended:

• Protection: Protect the joint from further injury by using pads (e.g., knee pads) or avoiding certain movements.
• Rest: Avoid the activity that triggered the pain. Give the joint time to recover without further irritation.
• Ice: Apply an ice pack (wrapped in a towel) to the affected area for 10-20 minutes every few hours to reduce swelling.
• Compression: A simple elastic bandage may help support the joint, though it should not be too tight.
• Elevation: If possible, keep the joint raised above the level of your heart to encourage fluid drainage.

Over-the-counter pain relief, such as ibuprofen or naproxen (if suitable for you), can help reduce both pain and inflammation. Always consult a pharmacist or read the patient information leaflet before starting new medication.

While many cases resolve with rest, professional medical advice is necessary if your symptoms do not improve. You should book a consultation if:

• The pain is severe enough to interfere with sleep or daily activities.
• Self-care measures have not worked after two weeks.
• The swelling is significant or keeps recurring in the same spot.
• You have a pre-existing condition like gout or rheumatoid arthritis that may be complicating the flare-up.

A GP can provide a physical examination and may recommend further treatments such as physiotherapy, a corticosteroid injection to reduce inflammation, or fluid aspiration (draining the bursa with a needle). In rare cases of chronic bursitis that does not respond to treatment, surgery to remove the bursa (bursectomy) may be considered.

If you are struggling with joint pain and suspect bursitis, an online GP consultation offers a convenient way to receive an initial assessment. During a video call, a clinician can discuss your symptoms, review your range of movement, and provide guidance on appropriate pain relief.

An online GP can also advise on necessary lifestyle adjustments or workplace modifications to prevent the condition from worsening. If your symptoms suggest bursitis and you require a period of rest to recover, they can issue a private sick note (Fit Note) for your employer. They can cũng refer you to a local physiotherapist or suggest when an in-person specialist referral is needed for imaging like an ultrasound or X-ray.