There are more than 150 bursae in the body and any can swell. Rest settles most cases in days to weeks, and one symptom means stop resting and call.
Shoulder pain that hurts when pressed, and hurts more the day after a job overhead, is often not the joint at all. It is the cushion in front of it.
A bursa is a small fluid filled sac between bone and the tissue moving over it. When one is irritated it swells, and the swelling is what hurts.
Below are the four signs that point at the bursa, the five reasons to call, and why rest is the treatment rather than the wait.
Four things bursitis does that arthritis usually does not
Mayo Clinic says bursitis is a painful condition affecting the small fluid filled sacs that cushion the bones, tendons and muscles near the joints, and that it happens when those sacs become swollen and irritated.
Four features separate it from a joint problem.
- Pressure hurts more than movement. Mayo Clinic says the joint hurts more when moving or pressed on. A bursa sits close to the surface, so leaning an elbow on a desk or lying on the sore shoulder is the giveaway.
- It swells and reddens on the outside. Mayo Clinic says the joint may look swollen and red, and notes redness is harder to see on Black or brown skin. Cleveland Clinic calls bursitis painful swelling in a small fluid filled sac.
- It followed a repeated job. Mayo Clinic says a common cause is repeated motion that puts pressure on a bursa, and gives three examples: throwing or lifting overhead, leaning on the elbows, and kneeling for tasks such as laying carpet.
- It arrived over days, not years. Cleveland Clinic says pain from an inflamed bursa may come suddenly or build over time, and Harvard Health says bursitis usually lasts only days or weeks. Joint wear does not work on that timetable.
The shoulder version is subacromial bursitis, the elbow version olecranon bursitis, the hip version trochanteric bursitis. Same problem, different cushion.
Five reasons to stop resting it and get it looked at
Cleveland Clinic says bursae cushion the spaces between bones and your muscles, tendons and skin, and that the most common causes of bursitis are overuse and too much pressure on a bursa.
Most cases settle with rest. Mayo Clinic names five where rest is the wrong plan.
Joint pain that gets in the way of daily activities. A flare you can work around is different from one that stops you.
A joint that does not move well. Loss of movement is not part of the standard picture.
A lot of swelling, redness, bruising or a rash in the area. Mayo Clinic notes again that redness is harder to see on Black or brown skin.
Sharp or shooting pain when exercising or overusing the joint.
A fever. Mayo Clinic lists infection among the causes of bursitis, and Harvard Health says infection is one of the rarer ones. A hot, swollen joint with a fever is not a rest and see situation.
Bursitis usually lasts for only days or weeks, but it can last months or years, especially if the cause, such as overuse, is not identified or changed.
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Harvard Health says that if you modify your activities and rest the joint, symptoms should go away within days or sometimes weeks. It also names the trap: bursitis can last months or years if the cause is not identified or changed.
That second half is the part people skip. Rest a shoulder a week, repeat the same overhead job, and the clock restarts.
Mayo Clinic's prevention list is changed causes, not exercises. Use kneeling pads if the job has you kneeling. Take breaks and mix repeated tasks with rest.
Keep a healthy weight. Mayo Clinic says being overweight raises the risk of hip and knee bursitis, and Harvard Health says bursitis is more common in people who are overweight, elderly or diabetic.
Strengthen the muscles around the joint, and warm up before tough activities. Mayo Clinic lists both as ways to protect it.
Mayo Clinic is also honest about the ending: bursitis often flares up again. Prevention is what decides how often.
Three bursitis beliefs that keep a flare going
Three ideas turn a two week problem into a two year one, and each has an answer.
Joint pain after 50 is arthritis. Not necessarily. Mayo Clinic says the most common bursitis sites are the shoulder, knee, elbow and heel, that it often follows repeated motion, and that pain worsens when the joint is pressed. Arthritis is on its list of causes, but the two are not the same and the treatment differs.
Work through it and it will loosen up. Harvard Health says bursitis can last months or years if the cause, such as overuse, is not identified or changed, and Mayo Clinic says treatment most often involves resting the joint and protecting it from further damage. Continuing the motion that caused it is the one reliable way to make it chronic.
An injection is the first move. It is not the first move. Harvard Health puts the corticosteroid injection after activity modification and rest, for pain that is intense or does not improve in a short period. Cleveland Clinic and Mayo Clinic both start with rest.
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This article is education, not medical advice. Mayo Clinic says to talk with your healthcare professional about joint pain that gets in the way of daily activities, a joint that does not move well, a lot of swelling, redness, bruising or a rash, sharp or shooting pain on use, or a fever. Infection needs treatment, not rest.