Bursitis - Treatment 

Treating bursitis 

Most cases of bursitis can be treated at home with self-care techniques and over-the-counter painkillers.

The pain usually improves within a few weeks, but the swelling may take longer to completely disappear.

Exactly how long it takes to recover may depend on where the bursitis is and whether it is caused by an infection (septic bursitis).

Self-care

There are a number of things you can do yourself to reduce the swelling in the affected joint. Rest the joint until your symptoms improve and avoid strenuous activities that are likely to cause additional pain, such as running.

Wearing padding may help protect the joint from further injury. For example, knee pads may help if you have bursitis in your knee joints.

Ice packs are also a good way of reducing inflammation and pain. Wrap an ice pack (or a bag of frozen vegetables) in a towel and apply it to the affected area for 10-20 minutes. Repeat this every few hours.

While sleeping, avoid lying on the side that has bursitis. If possible, raising the body part above the level of your heart may help reduce the inflammation. For example, you can prop your foot up on a pillow to raise your ankle. 

Painkillers such as paracetamol or ibuprofen can help to relieve the pain. Ibuprofen, or other non-steroidal anti-inflammatory drugs (NSAIDs) such as naproxen or diclofenac, can also be used to help reduce swelling.

Always read the patient information leaflet that comes with the medicine to check that it is suitable for you and that you are taking the correct dose.

Aspiration

If the swelling caused by bursitis is particularly severe, you may want to consider having the fluid drained out. This procedure, known as aspiration, can relieve the pain and improve the range of movement in your joint.

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 about two days afterwards.

Corticosteroids

If your bursitis symptoms are very severe or they do not respond to treatment, corticosteroid injections are another possible treatment option. Corticosteroids contain steroids, a type of hormone, and can be used to reduce inflammation.

Your GP can inject corticosteroids directly into the affected area. Possible side effects include the surrounding tissue wasting away and discolouration of the skin around the injection site. 

You will not be able to have a corticosteroid injection if you have septic bursitis, and cannot have more than three corticosteroid injections a year in the same area.

Antibiotics

Your GP will prescribe antibiotics if tests confirm that you have septic bursitis. These may include:

These will usually be taken as tablets or capsules two or four times a day for seven days. After seven days, your GP should 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 important that you finish the entire course, even if your symptoms improve. This will help to prevent the infection returning.

Referral

If your symptoms do not improve with treatment after a couple of months, 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 does not get better or reoccurs.

Surgery

In some cases, surgery may be recommended to remove the affected bursa, particularly where septic bursitis does not respond to antibiotics.

Surgery either involves removing the bursa completely, or making an incision in your skin and draining the fluid out of the bursa (incision and drainage).

Page last reviewed: 21/01/2013

Next review due: 21/01/2015

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Comments

The 7 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Allie23 said on 04 November 2014

Have just found this forum, and reading about all your ongoing struggles is very worrying for me. My daughter was diagnosed with trochanteric bursitis in her hip following a sports injury 3 years ago. After the usual painkillers and stretches advise by the GP (despite severe pain for over a year) we went private. Had MRI to confirm, cortisone injection and physio. Temporary relief but never went completely. Pain is now as bad as ever, she is only 18, very healthy, maintains a healthy diet, not overweight, keeps fit even though its becoming harder. She broke down last night, told me sleeping and even driving now painful. Really don't know where to turn for help. Have made another appointment with GP. Can anyone adivise anything we should be doing/asking for? So upsetting to see her like this.

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raverbaby88 said on 15 July 2014

Have been getting pain now for four years. Had MRI/Xray which didn't show up anything,1 year at physio (which was a waste of time they said I had lower back pain), 6 weeks acupuncture treatment (helped the pain very temporarily), 1 year at private chiro clinic who diagnosed bursitis and promised he would cure me in 4 months....but here I am today still suffering! I do the exercises but they don't work and too painful. The stretches are good but after 4 years i get on/off excruciating pain that now i am lying in bed unable to move. Seeing another GP next week to suss out some options.

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supernan1946 said on 30 April 2014

I have had an operation on my right hip for bursitis i was told it is not always successful unfortunately mine was not i continued to have the pain + additional pain around my lower back, I have now got a bursa on my left side and have approached my GP to have aspiration as anybody out there had their bursa drained, and more importantly does it work

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BHM95 said on 10 February 2014

I am 18 and discovered i had Bursitis in my knee last year. I had a corticosteroid injection in November to treat it. The pain is no longer as bad but it does still hurt when driving for a long time or doing exercise,also my knee is now slightly purple and there is a dent where the injection was. Is this normal or should i go back to see my GP?

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wendij22 said on 04 January 2014

@Bumblebee26: I know what you mean regarding being called to young for having these problems. I am 35 now, but for the last 10 years I had on and off attacks of Bursitis. No laughing matter. Usually I have to treat it with painkillers, rest, cooling and some light exercises, but I can tell you: I don't think there is much left of my right hip! There are plenty of young people and children with the same problems as we do - or worse - like Rheumatism or Artritis. So, keep looking for an answer. Ask your GP to see a Rheumatologist (excuse the spelling) and get yourself referred! I can't even have a nice lovely walk any more without making the pain worse, and even driving a car (because the hip joint is slightly tilted and therefore very painful) is an ordeal. Good Luck. There must be something better than just painkillers and stretching!

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Paininbum said on 28 November 2013

My GP has injected corticosteroid in my hip. Two days on it is very painful and my knee and outer lower leg very uncomfortable rather like a cramp sensation. I have had the bursitis for 30 odd years. I think it happened after bumping down icy steps. Sometimes it's not bad but I find it very hard to sleep on my right side. I just wish I could get this to go away. Nothing worse going on a longish flight and holidaying with this. I don't think people realise how debilitating the condition is. I missed out on a trip to the States because of it. Any suggestions please.

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Bumblebee26 said on 20 November 2013

I'm 26 and I've been suffering with hip bursitis for 2 years now after suffering trauma to the hip after falling off my bike. In the first year of having it I saw two different NHS physiotherapists, both of whom gave me some stretches and sent me on my way (one didn't even show me how to do the stretches, just sent a list to me in an email so I could have been doing them completely wrong!). The stretches did help to an extent, I stopped having pain all the time. However now, I'm still really restricted in activities I can do. If I do too much walking or exercise, or if I sit down too much the pain comes back and I end up limping which doesn't help the injury. I am not overweight and maintain a healthy lifestyle. It's particularly bad when it's cold outside. I feel really embarrassed by it because people say to me "oh your young, it can't be that bad, it'll go away eventually". But having had it for two years I feel like it's never going to go away and I'm never going to be able to do normal activities.

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