Bursitis is simply the inflammation or irritation of a bursa, which is a sac-like structure filled with lubricating fluid. It lies between a bone and opposing surface (e.g. skin) like a tiny water balloon with only a few drops of fluid in it, wedged between two surfaces. It serves to decreases rubbing, friction, and irritation between joints. Some of the key characteristics of bursae include:

  • A healthy bursa is thin. For example, a research study of a relatively large bursa located between the kneecap and skin showed the average bursa measurement to be about four centimeters in diameter and just a few millimeters thick.
  • Bursae vary in size depending on the individual and location in the body.
  • Some bursae are just beneath the skin’s surface while others are deep below muscles and other soft tissue.
  • An adult body contains about 160 bursae.
  • Some bursae are present at birth and others develop later as the result of frequent friction. For example, most people develop a bursa in the elbow called the olecranon bursa sometime after age 7.
  • Other bursae may develop depending on the individual. For example, a person who regularly wears constricting shoes or has abnormal foot anatomy may develop a bursa on the outside of the big toe joint.


Bursitis is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age, they are able to tolerate stress less, are less elastic, and are easier to tear. Overuse or injury to the joint at work or play can also increase a person’s risk of bursitis. Incorrect posture at work or home, poor stretching habits, or lack of conditioning before exercise can also lead to bursitis. An abnormal or poorly placed bone or joint (such as length differences in your legs) can put added stress on a bursa sac. Stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorder, or unusual medication reactions may also increase a person’s risk. In addition, an infection can occasionally lead to inflammation of a bursa.


Although bursitis can occur throughout the body, hip bursitis can lead to unique symptoms such as difficulty walking or problems laying on your side. Hip bursitis usually goes hand in hand with IT Band Syndrome due to one usually causing the other. Trauma to the hip from a fall or motor vehicle accident is common and an MRI might be warranted to rule out other to rule out other pathologies of the hip.


If bursitis is suspected, HEAT should be applied rather than ice unless it was caused by an infection. This is the #1 most common mistake when self-treating. Additionally, Therapeutic Ultrasound and further treatment of the surrounding tissue is highly effective in decreasing the inflamed structure. Graston Therapy is used to loosen the surrounded muscles to avoid continual flair ups. Chiropractic adjustments are made to the shoulder and neck to correct upper body imbalances, which can place abnormal stress on the shoulder joint.