Bursitis

Treatment Overview

Treatment for bursitis most often includes rest, ice, and taking pain relievers. Acetaminophen or nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce both pain and inflammation.

Bursitis is likely to improve in a few days or weeks if you immediately rest and treat the affected area. Take the following steps to treat bursitis:

• Rest the affected area and avoid any activity or direct pressure that may cause pain. Get enough sleep.
• Apply ice or cold packs as soon as you notice pain and tenderness in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for 72 hours. Continue applying ice (15 to 20 minutes at a time, 3 times a day) as long as it relieves pain. Although heating pads may feel good, ice will relieve pain and inflammation.
• Take pain relievers. Use acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, or aspirin, as directed for pain relief and to reduce bursitis inflammation. (Do not give aspirin to anyone younger than age 20 because of the risk of Reye's syndrome, a central nervous system complication in children.) Do not rely on medication to relieve pain in order to continue overusing a joint.
• Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move your joint through its full range of motion, even during the time that you are resting the joint area. This will prevent stiffness in your joint. As the pain goes away, continue range-of-motion exercises and add other exercises to strengthen the muscles around your joint.
• Gradually resume your activity at a lower intensity than you maintained before your symptoms began. Warm up before and stretch after the activity. Increase your activity slowly, and stop if it hurts. After the activity, apply ice to prevent pain and swelling. To avoid reoccurrence, try changing the way you do the activity that caused the pain and tenderness.
• Avoid tobacco smoke. Smoking impairs collagen production, which is necessary for wound and tissue healing.¹

Check with your health professional if bursitis is severe or does not respond to several days of home treatment, if the sore area becomes very hot or red, or if you have a fever. You may also want to call your health professional if you are more likely to get an infection because you have other health conditions such as diabetes, rheumatoid arthritis, lupus, or HIV/AIDS, or you take medications such as corticosteroids or immunosuppressants.

Severe or long-lasting bursitis is sometimes treated by removing excess fluid from a swollen bursa with a needle and syringe (aspiration), applying a pressure bandage to the area, or both. If the fluid shows signs of bacterial infection (septic bursitis), antibiotic treatment is necessary, possibly including a hospital stay for intravenous (IV) antibiotic therapy. Bursitis may also be treated with an injection of corticosteroid medication to reduce inflammation. Occasionally a bursa is surgically removed if it has not responded to treatment and is causing significant pain and disability.

Bursitis may return if you do not stretch and strengthen the muscles around the joint and change the way you do some activities. Your health professional may recommend physical therapy.

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Author:	Shannon Erstad, MBA/MPH	Last Updated: December 19, 2006
Medical Review:	Martin Gabica, MD - Family Medicine Nicola Maffulli, MD, PhD - Orthopedics
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