Bursitis Symptoms 

Bursitis causes pain and tenderness around  the affected bone  or tendon. The bursae sacs may swell, often making  movement difficult. The most commonly affected joints are the  shoulder, elbow, wrist and hand, knee, and foot. 

Shoulder

The subacromial (subdeltoid bursa) separates the major tendon (known as the supraspinatus tendon) from the overlying bone and deltoid muscle. Inflammation of this bursa is usually a result of  injury to surrounding structures-most commonly  the rotator cuff. This  is often referred to as "impingement syndrome." It is often difficult to tell  the difference between this type  of bursitis pain and a rotator cuff injury. Both cause pain in  the side  or front of the shoulder.

• Overhead lifting or reaching activities  are uncomfortable. 
• Pain is often worse  at night. 
• The shoulder will usually have decreased range  of active motion and be tender at specific spots. 

Elbow 

Olecranon bursitis is  the most common form of bursitis. Goose-egg-like, tender red swelling may appears just behind  the elbow. This area is at the top of one of the forearm bones called the ulna and  is known as the olecranon process. 

• The pain may increase if the  elbow is bent because tension increases over the bursa. 
• This bursa is frequently exposed to direct trauma (bumping your arm) or repeated motions from bending  and extending the elbow (while painting, for example). 
• Infection is common  in this bursa. 

Knee 

• Kneecap (prepatellar) bursitis: Swelling on  the front of the kneecap is usually associated with either chronic trauma (from kneeling) or an acute blow  to the knee. Swelling  may occur as late as 7-10 days after a single blow to  the area, usually from a fall. 
• Anserine bursitis: The anserine bursa  is fan shaped and lies among 3 of the major tendons at the knee.  The name anserine (gooselike) comes from  the shape of the swollen bursa. When restrained by  the 3 tendons,  the bursa looks  like a goose's foot.

1. This type of bursitis is most often seen in people with arthritis, especially overweight middle-aged women with osteoarthritis. 
2. The  pain is typically produced when  the knee is bent  and is particularly troublesome at night. People often seek comfort by sleeping with a pillow between their thighs. 
3. The pain can radiate to  the inner thigh and midcalf and usually increases  on climbing stairs and at extremes of bending and extending. 
4. The area of tenderness  is on the middle part  of the knee. 
5. Anserine bursitis also occurs as an overuse or traumatic injury among athletes, particularly long-distance runners. 

Ankle 

Retrocalcaneal bursitis occurs when  the bursa near  the Achilles tendon in  the ankle becomes inflamed. This is commonly caused by local trauma associated with wearing a poorly designed shoe (often high heels) or prolonged walking. It can also occur with Achilles tendonitis. 

Bursitis in this part of  the body often occurs as an overuse injury in young athletes, ice skaters,  and female adolescents transitioning to higher heels. The pain is usually on  the back of the heel  and increases with passive extension or resisted flexion. 

Buttocks 

Ischiogluteal bursitis causes inflammation of the ischial bursa, which lies  between the bottom of the pelvic bone  and the overlying gluteus maximus muscle (one side  of the buttocks). Inflammation can come from sitting for a long time on a hard surface  or from bicycling. 

• The pain occurs when sitting and walking. 
• There will be tenderness  over the pubic bone, which  may be made worse by bending  and extending  the leg. 
• The pain  may radiate down  the back  of the thigh. 
• Direct pressure over the area causes sharp pain. 
• The  person may hold  the painful buttock elevated when sitting. 
• The pain is worse when person is lying down  and the hip is passively bent. 
• The person may have difficulty standing on tiptoe on  the affected side. 

Hip 

The iliopsoas bursa is  the largest  in the body  and lies in front of, and deep to,  the hip joint. Bursitis here  is usually associated with hip problems  such as arthritis or injury (especially from running). 

• The pain of iliopsoas bursitis radiates down  the front  and middle areas  of the thigh to  the knee and is increased when  the hip is extended and rotated. 
• Extension  of the hip during walking causes  pain so  the person may limit  the stride  on the affected side and take a shorter step. 
• There may be tenderness in the groin area. 
• Sometimes a mass may be felt resembling a hernia. The person may also feel numbness  or tingling if adjacent nerves are compressed by  the inflamed bursa. 

Thigh 

The trochanteric bursa, part  of the thigh,  can be associated trochanteric bursitis, which occurs most frequently in overweight, middle-aged women. 

• It  causes deep, aching hip pain along  the side of the hip  that may extend into  the buttocks  or to the side of  the knee. 
• Pain  is aggravated  by activity, local pressure,  or stretching. 
• Pain is often worse at night.