In most cases, bursitis can be successfully treated using a combination of self care techniques and painkillers that are available over the counter from a pharmacist. The pain will usually improve within a few weeks, although the swelling may take longer to completely disappear. The exact length of time it will take to fully recover may depend on:
- where the bursitis is
- whether the bursitis is caused by an infection (septic bursitis)
If treated with aspiration (see below), bursitis in the elbow will usually get better in around two weeks, or in five weeks if it's infected. Septic bursitis of the knee usually gets better in three weeks if it's treated with aspiration.
Self care
Healthcare professionals usually recommend a self care management approach known as PRICE, which stands for:
- Protection
- Rest
- Ice
- Compression
- Elevation
You should follow these measures until your symptoms improve.
Protection
You may wish to wear padding to protect the joint from any further injuries. For example, you can wear knee pads if you have bursitis in your knee joints.
Rest
Rest the affected body part until your symptoms improve. Avoid any activity that causes additional pain.
Ice
Ice packs can be a very effective method of reducing the symptoms of inflammation (swelling) and pain. Wrap an ice pack in a towel and apply the towel to the affected area for 10 to 20 minutes. Repeat this every few hours. If you don't have an ice pack, you can use ice cubes or a bag of frozen vegetables wrapped in a towel.
Compression
Using an elastic bandage or dressing to compress affected joints can often help to relieve pain.
Elevation
If it's physically possible, elevating the affected body part above the level of your heart may help to reduce inflammation. For example, you can prop your foot up on a pillow to raise your ankle.
Painkillers
Painkillers, such as paracetamol or ibuprofen, are effective ways of treating pain. Ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAIDs), such as naproxen or diclofenac, will also help to reduce inflammation.
Always check the patient information leaflet that comes with the medicine to make sure it's suitable for you and that you're taking the correct dose.
Additional treatment
Aspiration
If the swelling that's caused by bursitis is particularly severe, you may want to consider having the fluid drained out in a procedure that's known as an aspiration. This can improve the range of movement in your joint and relieve pain.
During aspiration, your GP will use a needle to draw out the fluid before covering the area with a dressing. You'll need to avoid strenuous activity for around two days afterwards.
Corticosteroids
If your symptoms of bursitis are particularly severe or they fail to respond to treatment, corticosteroid injections are another possible treatment option. Corticosteroids contain steroids, a type of hormone, and can reduce inflammation.
Your GP can inject corticosteroids directly into the affected body part. Possible side effects of corticosteroid injections include:
- the surrounding tissue wasting away
- the skin around the injection changing colour
Corticosteroid injections can't be used if your bursitis is caused by an infection, or if your GP is unsure whether it's caused by an infection. You also can't have another corticosteroid injection if you've already had three or more in the same area within a year.
Antibiotics
If testing confirms that your bursitis is caused by infection, your GP will prescribe antibiotics. Possible antibiotics that you may take include:
- flucloxacillin
- erythromycin
- clarithromycin
These will usually be taken orally (as tablets or capsules) that you take two or four times a day for seven days. After seven days, you should return to your GP so that they can check how well you're responding to the antibiotics. If you still have signs of infection you may need to take antibiotics for another seven days.
If you're prescribed antibiotics, it's very important that you finish the entire course that you're given, even if your symptoms improve. This will help to prevent the infection from returning.
Referral
If your symptoms don't improve after two months of trying these treatments, your GP may refer you to a specialist. This may be:
- a rheumatologist – a specialist in conditions that affect the bones, muscles and joints
- an orthopaedic surgeon – a specialist in the surgical treatment of conditions that affect the bones, muscles and joints
You may also be referred if you have infected bursitis that doesn't get better after taking antibiotics, or if your infected bursitis reoccurs.
Surgery
In some cases, surgery to remove the affected bursa may be a possible treatment option. For example, if you keep getting septic bursitis or if other treatments don't work.
Incision and drainage is a surgical technique that may be recommended if your infection doesn't respond to antibiotics. This involves making an incision in your skin and through to the bursa so that the fluid can be drained out.
