Bursitis

Bursitis is inflammation of a bursa — a small fluid-filled sac that cushions bones, tendons and muscles near joints. The commonest sites are the shoulder, elbow ("student's elbow"), hip, knee ("housemaid's knee"), and heel.

Symptoms

• Localised pain, swelling, warmth over the affected area.
• Pain worse with movement or pressure on the spot.
• Stiffness.
• Usually no fever.

Red flags — rule out septic bursitis

• Rapidly swelling, very red, hot, painful bursa with fever — can be bacterial infection; needs same-day evaluation and drainage/antibiotics.
• Open skin over the bursa with swelling.
• Severe pain with systemic illness.

Causes

• Repetitive use or pressure (kneeling, leaning, desk work).
• Sudden injury.
• Rheumatoid arthritis, gout, other inflammatory conditions.
• Infection (septic bursitis).

Treatment

• Rest from aggravating activity; avoid pressure on the area.
• Ice 10-15 minutes, several times a day early.
• NSAIDs short-term.
• Physiotherapy — once the acute pain settles.
• Aspiration and steroid injection — for persistent non-infected bursitis.
• Antibiotics + drainage — for septic bursitis.
• Protective padding — knee pads, elbow pads — for occupational exposure (cleaners, plumbers, mechanics).