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Bursitis

Painful swelling of a bursa — one of the small, fluid-filled cushions around the shoulder, elbow, hip, knee and heel — usually from overuse or pressure. Most cases ease within a few weeks with rest and simple care, but an infected bursa needs a doctor the same day.

What is bursitis?

A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons or skin (MedlinePlus). Bursae help reduce friction when a joint moves. Bursae are found throughout the body, including around the shoulder, elbow, hip, knee and heel (AAOS OrthoInfo). Bursitis — painful swelling of a bursa — can affect any joint, but it’s most common in the shoulders, hips, elbows and knees (NHS). When a bursa is irritated, it fills with extra fluid and swells (AAOS OrthoInfo).

Bursitis is different from arthritis, which is usually a long-term breakdown of cartilage inside a joint, and from tendinitis, which is irritation of a tendon — the cord-like structure where a muscle attaches to bone. Tendinitis is often caused by injury or repetitive use, and tendinitis and bursitis often affect the same areas, such as the shoulders, hips, knees and ankles (American College of Rheumatology). See our arthritis guide; a separate MBHA guide to tendonitis is on the way.

Where it happens

  • Shoulder (subacromial bursitis), in the bursa between the rotator cuff tendons and the top of the shoulder blade: pain and stiffness when you lift your arm and reach overhead, often at its worst at night (AAOS OrthoInfo).
  • Elbow (olecranon bursitis), at the bony tip of the elbow. Swelling is often the first sign; it may not be noticed at first because the skin there is loose (AAOS OrthoInfo).
  • Outer hip (trochanteric bursitis): pain at the point of the hip that spreads down the outside of the thigh, typically worse at night, when lying on that hip, and when getting up from a chair (AAOS OrthoInfo). Doctors now often call outer-hip pain greater trochanteric pain syndrome (see below).
  • Front of the knee (prepatellar bursitis, “housemaid’s knee”): rapid swelling on the front of the kneecap that is tender and warm to the touch, with pain during activity but not usually at night (AAOS OrthoInfo).
  • Heel: in the foot, bursitis most often affects the heel and toes, and can come from repetitive motion or irritation from shoes (ACFAS FootHealthFacts). A bony bump on the back of the heel (Haglund’s deformity, or “pump bump”) that rubs against stiff-backed shoes often inflames the bursa between the Achilles tendon and the bone, causing pain, swelling and redness at the back of the heel (ACFAS FootHealthFacts).

Causes and risk factors

Symptoms

Common signs are a joint that is painful — usually a dull, achy pain — tender or warmer than the skin around it, swollen, and more painful when you move it or press on it. The area may also be red, which can be harder to see on brown or black skin (NHS). Bursitis pain can be very intense, during movement or even at rest (American College of Rheumatology).

Could it be infected? See a doctor the same day — or go to urgent care or the emergency department — if a swollen bursa comes with:

Infected (septic) bursitis must be treated more urgently than ordinary bursitis (AAOS OrthoInfo). Left untreated, the infection can spread to other parts of the arm or into the bloodstream and cause serious illness (AAOS OrthoInfo). It doesn’t always look obvious: in one report of three hockey players with septic bursitis, none had a visible skin wound and only one had a fever (Tuff and Chrobak, 2016). Don’t wait for a chiropractic, acupuncture or massage appointment, and never have an infected bursa massaged.

How is it diagnosed?

A provider usually diagnoses bursitis with a physical exam and your medical history (American College of Rheumatology). Expect questions about your symptoms, how long you’ve had them and your risk factors (AAOS OrthoInfo). X-rays can rule out a fracture or other bone problem, and CT or MRI scans can check for other soft-tissue injuries (AAOS OrthoInfo); imaging and blood tests are usually needed only if the problem keeps coming back or doesn’t go away (American College of Rheumatology). If infection or gout is a possibility, the provider may draw fluid from the bursa with a needle (aspiration) and send it to a lab (NHS, AAOS OrthoInfo).

How long does it last?

Bursitis can usually be treated at home and should go away in a few weeks (NHS). Shoulder pain from the rotator cuff and its bursa often improves gradually with nonsurgical care, though complete recovery can take several weeks to months (AAOS OrthoInfo). Bursitis can come back (NHS); people who have had elbow bursitis again and again often have bone spurs at the tip of the elbow (AAOS OrthoInfo). If a joint still hasn’t improved after 6 to 12 months, surgery may be needed (MedlinePlus).

When to see a provider: if symptoms haven’t improved, or are getting worse, after 1 to 2 weeks of home care, or you can’t move the joint (NHS); if pain worsens or doesn’t improve in a few weeks (American College of Rheumatology); if hip pain is stopping you from doing normal activities or affecting your sleep (NHS); or if it’s very difficult to move your arm or shoulder (NHS).

Side by side

Six approaches compared

For every condition we look at the same six approaches: what each involves, what it typically costs, and what a patient can realistically expect.

ApproachWhat it involves Estimated costWhat to expect
Conventional medicine (AMA) Rest and activity changes, ice, padding, over-the-counter pain relievers and physical therapy first; draining the bursa and a corticosteroid injection if needed; antibiotics for infection; surgery rarely. Medicare Part B covers medically necessary outpatient PT (20% of the approved amount after the deductible). National cash listings put a physical therapy treatment visit at about $42–$179 per session, and an initial evaluation at about $95–$308 (The Pricer, August 2026). Injection prices: being researched. Most cases heal within a few weeks. Injections often help for months but not for everyone; for outer-hip pain, education plus exercise led to more overall improvement than an injection at one year in one trial.
Chiropractic Soft-tissue work, stretching and exercise around the sore joint, plus help with posture and movement habits — never on an infected bursa. About $90–$200 for a first visit and $55–$100 for follow-ups without insurance. Medicare covers only spinal adjustments for subluxation. No controlled trials for bursitis itself — only single case reports. Exercise-based care fits the research best.
Acupuncture Needle treatments for pain around the hip, shoulder or other sore joint, alongside medical care and exercise. About $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90. Not well studied for bursitis. One very-low-certainty review found dry needling no different from a steroid injection for outer-hip pain. Sterile needles matter.
Herbal medicine No herb or supplement is proven for bursitis. Turmeric (curcumin) is sometimes tried, based on osteoarthritis research. Cost estimate being researched. Evidence comes from knee osteoarthritis, not bursitis. Watch for side effects, interactions and products tainted with hidden drugs.
Massage therapy Gentle work on tight muscles around the hip, shoulder or knee — not direct pressure on a swollen bursa, and never on an infected one. At one national chain, about $125–$160 for a 60-minute massage for non-members, or memberships of about $70–$90 a month; prices vary by location. Often part of physical therapy, but not proven for bursitis itself; short-term relief for neck and shoulder pain in general.
MBHA Wellness Coach Changing repetitive tasks, kneeling and elbow pads, better posture and technique, warm-ups, strength and flexibility, a healthy weight, and a gradual return to activity. Cost estimate being researched. Supports — never replaces — medical care. These habits lower the chance of bursitis coming back.

Approach 1 of 6

Conventional medicine (AMA)

Bursitis can usually be treated at home (NHS). Your provider will likely ask about signs of infection, such as fever or chills, because infected bursitis needs a different treatment plan (AAOS OrthoInfo).

1. Rest, activity changes and padding

2. Ice, heat and elevation

An ice pack wrapped in a towel, held gently on the area for short periods every few hours, can ease pain and swelling (NHS). Heat or cold packs can also ease shoulder pain (NHS), and a physical therapist treating hip bursitis may use ice or heat (AAOS OrthoInfo). Raise a swollen knee when you rest (AAOS OrthoInfo).

3. Over-the-counter pain relievers

NSAIDs such as ibuprofen or naproxen, or acetaminophen, can ease pain (American College of Rheumatology); acetaminophen is an alternative if you can’t take NSAIDs (AAOS OrthoInfo). Use NSAIDs cautiously and for limited periods — they can cause side effects with certain health conditions or medicines (AAOS OrthoInfo). We don’t list doses; ask your doctor or pharmacist what is safe for you.

4. Physical therapy and exercise

For the hip, a physical therapist may teach stretches for the IT band and exercises for hip strength and flexibility (AAOS OrthoInfo). For the shoulder, a physical therapist works first on restoring motion with stretching, then, once pain is improving, on strengthening the rotator cuff muscles and on your overall posture (AAOS OrthoInfo); shoulder exercises kept up for 6 to 8 weeks can help stop pain from returning (NHS). For bursitis at the back of the heel, stretching exercises help relieve tension on the Achilles tendon (ACFAS FootHealthFacts). An occupational therapist can help with things that make daily life easier, such as walking aids (NHS). For outer-hip pain, see the evidence for education plus exercise below.

5. Draining the bursa and corticosteroid injections

If swelling and pain don’t respond, your doctor may drain the bursa with a needle and inject a corticosteroid, a stronger anti-inflammatory than pills (AAOS OrthoInfo); for the elbow, this is usually considered after 3 to 6 weeks of other care (AAOS OrthoInfo).

6. Antibiotics for infection

Infected bursitis is treated with antibiotics (NHS, AAOS OrthoInfo). Antibiotics can be taken by mouth, or by injection or IV, which is usually for more serious infections (MedlinePlus). Your doctor may start them before lab results come back, and may drain the bursa to relieve symptoms and identify the germ (AAOS OrthoInfo). Follow the directions carefully and finish your medicine even if you feel better (MedlinePlus). If gout is behind the bursitis, treating the gout may ease pain and swelling (American College of Rheumatology).

7. Surgery (rarely)

Surgery is rarely needed (NHS, AAOS OrthoInfo). It may be considered when an infection doesn’t clear with antibiotics and drainage, or when non-infected bursitis keeps causing symptoms despite other treatment; removing the bursa is usually done as an outpatient procedure (AAOS OrthoInfo, AAOS OrthoInfo). Surgery may be needed if a joint still hasn’t improved after 6 to 12 months (MedlinePlus). The hip works normally without the bursa (AAOS OrthoInfo), and an elbow bursa usually grows back as a normal, non-inflamed bursa over several months (AAOS OrthoInfo).

What it costs

  • Physical therapy: Medicare Part B covers medically necessary outpatient PT when your provider certifies you need it; you pay 20% of the approved amount after the deductible (Medicare.gov). Cash-price estimate being researched.
  • Office visits, aspiration, corticosteroid injections, imaging and surgery: MBHA cost estimate being researched.

Find a medical doctor in our directory

Approach 2 of 6

Chiropractic

Some people with a sore shoulder, hip or knee see a chiropractor. It’s worth knowing what the research does — and doesn’t — show.

What the research says

  • For bursitis itself, we found no controlled trials. The chiropractic literature on bursitis is mostly single case reports — for example, one woman with calcium deposits in a hip bursa who improved after two weeks of ultrasound, ice massage, electrical stimulation and lower-back and pelvic manipulation (Gerber and Herrin, 1994). A single case can’t show that a treatment works.
  • Spinal manipulation has been studied mainly for low back and neck pain, where it may bring small or modest improvements (NCCIH) — not for bursitis.
  • Exercise is what the evidence supports. For outer-hip pain, a 2024 review found exercise slightly reduced pain over the long term and recommended it as first-line treatment (Kjeldsen et al., 2024). If you see a chiropractor, ask whether the plan includes the stretching and strengthening your bursitis needs.

Safety

  • Never have manipulation or soft-tissue work on a bursa that might be infected — see the warning signs above. Septic bursitis can be hard to tell apart from ordinary bursitis without testing the fluid, so clinicians are urged to stay alert even when there is no wound or fever (Tuff and Chrobak, 2016).
  • Mild, short-lived side effects such as more pain, stiffness or headache often follow spinal manipulation and usually go away within 24 hours; serious problems, including strokes involving neck arteries, have been reported but are very rare (NCCIH).

What it costs

  • Without insurance: a first appointment commonly runs about $90–$200 and a follow-up visit about $55–$100 (The Pricer).
  • With insurance: what you pay depends on your plan’s copay, deductible, coinsurance and visit limits, so ask your insurer and the office before the first visit (The Pricer).
  • Medicare covers only adjustments of the spine to correct a subluxation, not other services or tests a chiropractor orders, such as X-rays, massage or acupuncture; you pay 20% of the approved amount after the deductible (Medicare.gov).

Find a chiropractor in our directory

Approach 3 of 6

Acupuncture

Acupuncture is sometimes used for painful shoulders and hips, but there is very little research on bursitis specifically, so any benefit is unproven.

What the research says

  • Bursitis: MBHA found no good-quality trials of traditional acupuncture for bursitis.
  • Dry needling (a related needling technique, not traditional Chinese acupuncture): a 2021 review found no difference between dry needling and a corticosteroid injection for greater trochanteric pain syndrome, but the evidence was of very low certainty and larger, better trials are needed (Sousa Filho et al., 2021).
  • Other pain: acupuncture may help back and neck pain and knee osteoarthritis pain, though some of its benefit appears to come from nonspecific effects (NCCIH). Those findings don’t tell us how it works for bursitis.

Safety

Relatively few complications have been reported, but problems have come from non-sterile needles and poor technique; the FDA requires acupuncture needles to be sterile and single-use (NCCIH). Sterile technique matters around joints: in Australia, an outbreak of serious MRSA infections — including infected joints and bursae — was traced to one medical practitioner’s breakdown in sterile technique during acupuncture and joint injections (Murray et al., 2008). Never have needles placed into or near a bursa that might be infected.

What it costs

Published cash prices run about $125–$230 for a first private visit and $90–$185 for follow-ups; community clinics about $50–$90 a visit (The Pricer).

Find an acupuncturist in our directory

Approach 4 of 6

Herbal medicine

Is any herb proven for bursitis?

No. MBHA found no herb or supplement that has been tested and shown to help bursitis. Online claims usually borrow from research on other conditions.

Turmeric (curcumin)

Turmeric is promoted for osteoarthritis, and early evidence for curcumin taken by mouth for knee osteoarthritis pain is positive, but higher-quality studies are needed; it’s unclear whether curcumin ointment helps (NCCIH). None of this research is about bursitis. Turmeric can cause nausea, acid reflux, stomach upset or diarrhea; liver damage has been reported with highly absorbable curcumin products; and turmeric supplements may be unsafe in pregnancy (NCCIH).

Products to be careful with

  • The FDA has warned about supplements promoted for arthritis or pain that were secretly tainted with prescription drugs, which could cause side effects or harmful interactions (NCCIH).
  • Some herbs interact with medicines — for example, ginkgo with the blood thinner warfarin raises the risk of major bleeding (NCCIH).

Before you take any herb or supplement, show it to your doctor or pharmacist — especially if you take a blood thinner, have liver problems, or are pregnant (NCCIH, NCCIH). We don’t list doses here, and no supplement treats an infected bursa — that needs a doctor the same day.

Approach 5 of 6

Massage therapy

Massage can’t drain or heal a bursa, but it is often part of physical therapy for the surrounding muscles. For hip bursitis, a physical therapist may use rolling therapy (massage) alongside stretching, ice or heat (AAOS OrthoInfo).

What the research says

  • Bursitis: we found no controlled trials. In a survey of 361 physiotherapists in Australia, New Zealand and Ireland, 90% used massage for outer-hip pain, but the authors noted that some add-on treatments are used without clear rationale or supporting evidence; education plus exercise is the approach in line with the evidence (French et al., 2020).
  • A 1993 report of two patients describes transverse friction massage for chronic hip and shoulder bursitis, and notes that earlier writing had discouraged friction massage for bursitis (Hammer, 1993). Two cases can’t show that it works.
  • Neck and shoulder pain in general: massage may help, but benefits may last only a short time (NCCIH).

Safety

Bursitis care means avoiding pressure on the swollen bursa (AAOS OrthoInfo, NHS), so MBHA suggests asking your therapist to work gently on the muscles around it rather than on the bursa itself — and to skip the area completely if it is red, hot or you have a fever. Rare serious problems such as a blood clot, nerve injury or broken bone have been reported, some with vigorous deep-tissue massage or in older adults (NCCIH).

What it costs

  • Prices vary by location. At one national chain, franchise price lists show about $125–$160 for a 60-minute massage for non-members and about $65–$90 for members, whose memberships run about $70–$90 a month; tips are extra (The Pricer).

Find a massage therapist in our directory

Approach 6 of 6

MBHA Wellness Coach

Bursitis can’t always be prevented, but there are things you can do to keep it from getting worse or coming back (AAOS OrthoInfo, NHS). An MBHA Wellness Coach can help you change those habits, alongside — never instead of — your medical care.

Change repetitive tasks

Pads and protection

Warm up, stretch and strengthen

Weight

Being overweight puts more pressure on your joints (NHS). For hip bursitis, losing weight if you need to can help keep it from getting worse (AAOS OrthoInfo).

A gradual return to activity

While you heal, avoid the activities that make symptoms worse (AAOS OrthoInfo), and swap in a low-impact activity, such as cycling, until knee bursitis clears up (AAOS OrthoInfo). With a sore shoulder, keep gently moving it, but don’t make up your own strenuous exercises or use heavy gym equipment (NHS). Seek medical attention if pain worsens or doesn’t improve in a few weeks (American College of Rheumatology).

Another approach

Outer hip pain: greater trochanteric pain syndrome

For years, pain on the outside of the hip was usually diagnosed as trochanteric bursitis and treated with NSAIDs, corticosteroid injections and physical therapy. Doctors now often use the broader term greater trochanteric pain syndrome (GTPS), which includes trochanteric bursitis, snapping hip and problems with the gluteal (abductor) tendons (Redmond et al., 2016). One review describes the most common underlying problem as wear or tearing of the gluteus medius and minimus tendons where they attach to the hip bone, with inflammation not a major feature (Torres et al., 2018).

What the research says about treatment

  • Education plus exercise vs. an injection: in the LEAP trial, 204 adults with gluteal tendinopathy (the main condition within GTPS) received an eight-week, physiotherapist-led program of education about managing load plus exercise, one corticosteroid injection, or a “wait and see” approach. At eight weeks both treatments beat waiting, and education plus exercise did better than the injection. At one year, education plus exercise still led to more people reporting overall improvement than the injection, although pain levels were similar (Mellor et al., 2018).
  • Exercise as first-line care: a 2024 review of six trials found that, over the long term, exercise slightly reduced hip pain and improved function compared with control treatments, and was better than an injection at producing meaningful overall improvement. The authors recommend exercise as first-line treatment but note the evidence comes from few trials (Kjeldsen et al., 2024).
  • Injections still have a place: injections may give months of relief (AAOS OrthoInfo), and one review rated corticosteroid injections among the most effective conservative options (Torres et al., 2018). Ask your provider how an injection would fit with an exercise program.

In practice: if you have outer-hip pain, ask about a physical therapist who can guide a strengthening program and teach you how to manage the load on your hip. See your provider if hip pain is getting worse, keeps coming back, or hasn’t improved after 2 weeks of home care (NHS).

In their own words

Wellness and lifestyle testimonials

Please read first. These are personal experiences, not medical advice. MBHA makes no medical claims and does not claim any product treats bursitis. A joint that is hot, red and swollen, especially with a fever, needs urgent medical care because it can be infected. Get any new or lasting joint pain checked so the cause is known, and never stop or change a prescribed medicine or injection plan because of anything you read here. Magnets can interfere with pacemakers and insulin pumps — ask your doctor first if you use one.

My bursitis needed a cortisone injection every three to four weeks. After a week on a magnetic sleep system I was sleeping solidly for the first time in a long while (I used to wake three to five times a night), and over the next four to five weeks my bursitis gradually eased.

— Peggy

I had bursitis in my hip. A friend loaned us a magnetic sleep pad, and within four days my pain had eased. We bought our own system before she could have hers back!

— Lucy

I started wearing a magnetic necklace for migraines. After about a week my migraines eased, and my shoulder and collarbone, which had been aching from bursitis, no longer hurt. That was a welcome side effect.

— Lynn

I have had bursitis in my shoulder for many years. What has helped me most is rolling a hand-held magnetic device around the shoulder several times a day, and wearing a magnetic necklace that I rarely take off. When I notice tightness starting, I use the device and get relief within minutes, and the necklace seems to have helped most of the problem fade.

— Name withheld

Shared with first names only. Lightly edited for length and spelling.

Member stories

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Sources

This page is for education only and is not medical advice. Costs are typical U.S. ranges and estimates; yours will depend on your provider, location and insurance. Talk with your doctor before starting, stopping or combining any treatment. In an emergency, call 911. See our disclaimer.

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