Treatment Overview
Living with bursitis can turn simple movements into painful ordeals. The condition involves the inflammation of the small, fluid-filled sacs (bursae) that cushion the bones, tendons, and muscles near your joints. Whether it strikes the shoulder, hip, elbow, or knee, the resulting stiffness and sharp pain can make daily tasks like dressing, walking, or lifting objects surprisingly difficult. Restoring comfort and mobility is the primary focus of care, allowing individuals to return to their work and hobbies without constant guarding against pain.
Because bursitis can result from repetitive motion, sudden injury, or occasionally an infection (septic bursitis), treatment plans are not one-size-fits-all. While many cases of overuse bursitis resolve with rest and home care, more persistent or infected cases require medical intervention. The choice of therapy depends heavily on whether the bursa is infected and the severity of the inflammation (National Institute of Arthritis and Musculoskeletal and Skin Diseases, 2023).
Overview of treatment options for Bursitis
The main goals of treating bursitis are to reduce inflammation, alleviate pain, and prevent the condition from becoming chronic. For the vast majority of cases caused by overuse or injury (aseptic bursitis), the initial approach involves the “RICE” method of rest, ice, compression, and elevation combined with anti-inflammatory medications.
When these conservative measures fail to provide relief, or if the pain is severe, doctors move to stronger medical treatments to target the inflammation directly. If the bursa is infected, the treatment goal shifts immediately to eliminating the bacteria to prevent the infection from spreading. While physical therapy and temporary immobilization are often used alongside drugs, medications remain the primary tool for managing the acute biological process of inflammation and infection.
Medications used for Bursitis
Doctors utilize specific drug classes to dampen the body’s inflammatory response or fight bacterial invaders.
Nonsteroidal anti-inflammatory drugs (NSAIDs): This class is the standard first-line treatment for bursitis caused by injury or overuse. Medications such as ibuprofen, naproxen, or aspirin are widely used to lower pain levels and reduce swelling. Clinical experience suggests that taking these medications on a scheduled basis for a short period, rather than just when pain spikes, is often more effective at breaking the cycle of inflammation. Topical versions of these drugs (creams or gels) are also available for patients who cannot tolerate oral medication.
Corticosteroids: For inflammation that does not respond to oral NSAIDs, doctors often utilize corticosteroids. These are typically administered as a targeted injection directly into the affected bursa. Drugs like methylprednisolone or triamcinolone provide potent, localized relief. Studies show that a corticosteroid injection can offer rapid reduction in pain and swelling, often resolving symptoms with a single treatment, though they are generally not used if infection is suspected.
Antibiotics: If the bursitis is caused by an infection (septic bursitis), antibiotics are essential. The choice of drug depends on the specific bacteria causing the infection, with Staphylococcus aureus being a common culprit. Oral antibiotics like cephalexin or clindamycin are frequently prescribed. In severe cases, intravenous antibiotics may be required in a hospital setting.
How these medications work
The medications used for bursitis target the chemical processes that cause heat, swelling, and pain.
NSAIDs relieve pain and inflammation by blocking cyclooxygenases (COX), enzymes that produce pain- and inflammation-triggering prostaglandins. This inhibition reduces fluid and nerve sensitivity in the bursa.
Corticosteroids mimic cortisol, acting as a powerful local immune “off switch.” They constrict blood vessels and prevent immune cell leakage into the bursa, quickly decreasing pressure and pain.
Antibiotics kill infection-causing bacteria by attacking their cell walls or internal machinery, allowing the bursa to heal.
Side effects and safety considerations
While effective, these medications carry risks that must be managed.
NSAIDs can cause GI irritation (heartburn, nausea, ulcers), kidney strain, and increased blood pressure, and should be taken with food.
Corticosteroid injections are generally safe but may cause temporary blood sugar spikes or facial flushing. Frequent injections into the same joint are discouraged due to potential tendon weakening.
Antibiotics can cause digestive upset or allergies. Finish the full course to prevent recurrence. Seek immediate medical attention for spreading redness, excessive heat, or fever, as septic bursitis can lead to a bloodstream infection.
Since everyone’s experience with the condition and its treatments can vary, working closely with a qualified healthcare provider helps ensure safe and effective care.
References
- Mayo Clinic. https://www.mayoclinic.org
- National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov
- American Academy of Orthopaedic Surgeons. https://orthoinfo.aaos.org
- MedlinePlus. https://medlineplus.gov
Medications for Bursitis
These are drugs that have been approved by the US Food and Drug Administration (FDA), meaning they have been determined to be safe and effective for use in Bursitis.