Our experienced private doctors here at London Doctors Clinic are here for any last minute concerns that those running the London Marathon this weekend might have! In fact, we're open 7 days a week, with short-notice and even walk in clinic appointments available every day! 

Following on with our theme of marathon running and sports injuries, today we focus on a little known sports injury that could be the cause of your painful aches! If it's not arthritis, torn ligaments, gout or damaged muscle - could it be bursitis?


What Is Bursitis?

Bursae are small, fluid-filled sacs that form in the joints. These can either be between bones and the overlying muscles (known as deep bursae), or between bones and tendons/ skin (known as superficial bursae).

In bursitis, bursae become become irritated or inflamed. Inflammation causes painful swelling and extra fluid to be made, which can feel like a soft, tender lump under the skin. There are over 150 bursae in the human body, but the joints that are typically affected by bursitis are the shoulder, elbow and hip.


Bursitis Symptoms

The most common symptoms are pain, swelling and tenderness over the affected joint. The joint may also be stiff or warm to touch. A fever may indicate that the bursitis is caused by an infection.


What Causes Bursitis?

1. Injury

The most common cause of bursitis is injury to the joint, usually due to overuse of the joint or repetitive movement. For example, runners have a high incidence of bursitis, (as much as 10%). Bursitis can also be caused by spending long periods of time against a hard surface or by trauma, such as falling on your knees.

Types of bursitis include:

  • Knee bursitis (prepatellar bursitis)
    • Also known as "housemaid's knee". This is often caused by kneeling regularly for a long time or repetitive knee movements.
  • Hip bursitis (Two types):
    • Trochanteric bursitis
      • Both hips are usually affected.
    • Ischial bursitis 
      • Also known as Weaver’s bottom.
      • This is often caused by sitting on hard surfaces for a long time.
  • Achilles tendon bursitis
    • This is often caused by excessive walking, especially in inappropriate shoes including high heels.
  • Elbow bursitis (olecranon bursitis)
    • This is also known as student’s elbow.
    • This can be due to injuries, or leaning on hard surfaces, like desks, for long periods of time.
  • Shoulder bursitis (subacromial bursitis)



Achilles tendon bursitis is caused by excessive walking, especially in inappropriate shoes!


2. Infection

Superficial bursae, like those in the elbow, lie close to the skin. As a result, breaks in the skin, caused by insect bites, wounds or scrapes can allow bacteria to get into the joint. A hot, swollen and red joint accompanied by fever may indicate an infectious cause i.e. septic bursitis.


3. Pre-existing medical conditions

Bursitis may also be caused by inflammatory conditions such as:

  • Gout
  • Pseudogout
  • Rheumatoid arthritis
  • Scleroderma
  • Ankylosing Spondylitis
  • Lupus


4. Obesity

Being overweight can put extra strain on the joint and cause bursitis.


Bursitis Diagnosis 

When you see a doctor, they will ask you questions about your symptoms and will physically examine you.

If the doctor suspects septic bursitis, they may take a sample of fluid from the affected joint and send it off for its contents to be analysed. Other tests, like blood tests, may be needed if the doctor suspects that another disease is causing the bursitis.


Bursitis Treatment

Most cases of bursitis improve with rest and over the counter painkillers such as ibuprofen and paracetamol, which help to reduce inflammation. Ice packs and elevating the joint can also help relieve pain and swelling. Pain usually improves within a few weeks, but the swelling may last longer to settle down.

If septic bursitis is diagnosed, you may need to have the fluid from the infected area drained and receive antibiotics. 

In more severe or complicated cases, steroids may be used. If your symptoms are not improving and an underlying inflammatory condition is suspected, your GP may think about referring you to a rheumatologist.

If the above treatments fail, you may be referred to an orthopaedic surgeon who can remove the bursae.


How Can I Prevent Bursitis From Happening Again?

As most cases of bursitis are caused by injury to joints, preventing further bursitis involves looking after your joints! 

This includes:

  • Taking breaks from repetitive movements
  • Warming up and stretching properly before exercise
  • Wearing appropriate footwear, especially if you walk or run extensively
  • Protecting your joints from hard surfaces (for example, by wearing knee pads or bracing)
  • Strengthening the muscles around the joint using exercises
  • Managing your weight



It is important to wear appropriate footwear, especially when running! 


If you are worried about a swollen, painful joint, why not book an appointment with London Doctors Clinic? We now have 12 GP surgeries located throughout London, so it should never be too hard when you are in search of a "clinic near me". We can look into a cause and aid you with recovery exercises, as well as refer you to a physiotherapist or other specialists if needed. 

 By Samara Linton