What Is the Best Treatment for Bursitis?

Bursitis treatment depends on its cause and location. Treatment can include the RICE method, home remedies, nonsteroidal anti-inflammatory drugs (NSAIDs), steroid injections, physical therapy, antibiotics, and surgery.

Bursitis is inflammation or irritation of the bursae (plural of “bursa”), which are fluid-filled sacs around joints and tendons that function to reduce friction from movement and to provide cushioning between bones, tendons, muscles, and skin.

Bursitis can involve nearly any joint in the body, but some joints are affected more often than others. Common locations for bursitis include: 

• Shoulder (subacromial bursitis)  
• Upper back (scapulothoracic bursitis) 
• Elbow (olecranon bursitis) 
• Pelvis (ischial bursitis) 
• Hip
  • Greater trochanteric pain syndrome (formerly called trochanteric bursitis) 
  • Iliopsoas bursitis 
• Knee
  • Prepatellar and infrapatellar bursitis 
  • MCL bursitis 
  • Pes anserinus pain syndrome 
• Heel (retrocalcaneal bursitis) 

Bursitis Treatment

Treatment depends on the cause and the location of the bursitis. The best way to treat bursitis involves rest and protecting the joints, relieving inflammation and pain, treating any infection, preserving range of motion, avoiding complications, and preventing recurrence.

Lifestyle modifications to protect the joints include: 

• The RICE method:
  • Rest
  • Ice the affected area
  • Compression with a compression bandage or stocking
  • Elevation of affected area
• Heat (e.g., a heating pad) 
  • More effective for deeper forms of bursitis, such as the hip, shoulder, or inner knee
• Avoid or modify activities that cause pain
• Use pads or cushions for kneeling or sitting
• Use splints or braces to limit movement of the affected joint
• Modify footwear to reduce pressure on the back of the heel (e.g., using a pad inside the shoe to lift the heel or cutting a “V”-shaped groove into the back of a shoe)
• Custom-fitted devices to wear over the elbows to protect them and prevent fluid build-up

Medications used to treat bursitis include: 

• Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation
  • Ibuprofen (Advil, Motrin) 
  • Naproxen (Aleve)
  • Aspirin
  • Topical NSAIDs such as diclofenac gel
• Steroid injections for pain and inflammation 
  • Used when the affected area is deep under the skin but not for superficial types of bursitis
  • Only provides short-term pain relief for several weeks

Other measures to treat bursitis include: 

• Physical therapy
  • Exercises depend on the type and severity of bursitis but may include: 
    • Stretching
    • Strengthening
    • Range of motion
• Treating infection
  • Septic bursitis is a serious condition that needs to be treated right away with antibiotics and draining infected fluid from the bursa
• Surgery
  • Rarely, surgery is performed to remove all or part of the affected bursa (bursectomy)