Bursitis Treatment: Causes, Management, and When Surgery Is Considered
Bursitis is inflammation of the small fluid-filled sacs (bursae) that cushion bones, tendons and muscles near joints. It commonly causes localized pain, swelling and stiffness that can affect daily activities such as walking. Treatment ranges from rest and medication to targeted physical therapy and, rarely, surgery. This article explains common treatment options, what to expect for hip involvement, and how care may differ for older adults.
This article is for informational purposes only and should not be considered medical advice. Please consult a qualified healthcare professional for personalized guidance and treatment.
What is bursitis and what causes it?
Bursitis arises when a bursa becomes irritated or inflamed. Causes include repetitive motion, prolonged pressure, sudden injury, or underlying inflammatory conditions such as gout or rheumatoid arthritis. Bursitis most often affects shoulders, elbows, hips and knees. Symptoms include localized tenderness, warmth, and reduced range of motion. Diagnosis typically relies on history and physical exam; imaging (ultrasound or MRI) and fluid aspiration are used when infection or other conditions are suspected. Identifying the trigger—overuse, mechanical stress, or systemic disease—helps shape effective treatment and recovery plans.
How does bursitis affect walking and mobility?
When bursitis involves the hip, knee or ankle, pain can alter gait and make walking uncomfortable. Avoiding pressure on the affected side often causes limp or compensatory motion that may strain other joints. Short-term strategies include activity modification, using a cane or other assistive device, and targeted rest. Physical therapy emphasizes gentle stretching, strengthening of surrounding muscles, and gait training to restore normal walking patterns. Addressing walking mechanics early can prevent secondary issues such as muscle imbalance, lower-back pain, or falls.
What are non-surgical treatments for hip bursitis?
Non-surgical care is the first line for hip bursitis and focuses on symptom control and restoring function. Typical measures include short-term relative rest, ice or cold packs, oral anti-inflammatory medications when appropriate, and corticosteroid injections into the bursa for persistent inflammation. Physical therapy targets hip stabilizers, iliotibial band mobility, and posture to reduce recurrence. Weight management and footwear adjustments can relieve pressure during walking. Most cases improve with conservative care over weeks to months; monitoring for infection or worsening symptoms is important.
When is surgery considered for bursitis?
Surgery is uncommon and generally reserved for cases that fail comprehensive conservative treatment or when there’s chronic bursitis with significant functional limitation, recurrent bursae tears, or infection not responding to antibiotics. Surgical options vary by location: bursectomy (removal of the inflamed bursa), debridement of damaged tissue, or addressing underlying structural problems like bone spurs. Outcomes depend on the specific joint, patient health, and rehabilitation. Before surgery, clinicians typically trial extended non-surgical care, imaging confirmation, and discussion of risks, benefits, and realistic recovery timelines.
How is bursitis treatment adapted for the elderly?
Treatment for elderly patients balances symptom relief with safety and functional goals. Older adults may have coexisting arthritis, decreased muscle strength, or slower tissue healing, so clinicians emphasize fall prevention, pain control with careful medication choices, and progressive physical therapy tailored to tolerance. Injections can be effective but require consideration of comorbidities and blood-thinning medications. Surgery may be considered when pain severely limits mobility or quality of life, but risks are weighed more cautiously. Coordinated care—including primary care, orthopedics, and physiotherapy—supports recovery while maintaining independence.
Conclusion
Bursitis treatment commonly begins with conservative measures—activity modification, physical therapy, and targeted medications or injections—and progresses to surgery only when necessary. Hip involvement and difficulties with walking require focused rehabilitation to restore gait and prevent secondary problems. In elderly patients, individualized plans consider comorbidities and functional goals. For persistent, worsening, or suspicious symptoms (fever, rapidly increasing swelling, or signs of infection), seeking evaluation from a healthcare professional is advisable.
