Joint pain, especially in the hips and shoulders, can sideline the best of us. But sometimes determining the cause of joint pain can be tricky.
Two conditions—arthritis and bursitis—have similar symptoms, which include stiff, achy joints; pain that gets worse while moving, especially after a period of inactivity; and pain that might keep you awake at night. Each condition comes with its own set of symptoms, causes, prognosis and treatment. The key difference is that bursitis will eventually go away, while symptoms of arthritis may lessen but will never completely disappear. (Mayo Clinic, 2020)
Evaluation by a medical professional is the best way to distinguish between arthritis and bursitis, for which the treatment approach and long-term outlook are quite different. (Silver, 2020)
So which is it, A or B—arthritis or bursitis—that’s causing your joint pain?
Arthritis is a chronic condition that damages bone, cartilage, and joints. In its various forms, arthritis is progressive and incurable, meaning the aching, stiffness, and limited mobility are likely to worsen over time. And while the pain can be alleviated, the damage cannot be reversed.
The two most common types are osteoarthritis, caused by a wearing away of the cartilage that protects bones from rubbing against each other, and inflammatory arthritis, an immune system disorder in which the body’s defenses mistakenly attack the lining of the joint capsule. The resulting inflammation and swelling can eventually destroy cartilage and bone.
The main risk factors for arthritis are family history, gender, and age, although other factors that contribute to weakening bones, such as smoking, lack of exercise or poor diet, may also increase your risk. (Mayo Clinic, 2020) The most common signs of arthritis include pain, stiffness, swelling, and decreased range of motion in the joint. Be sure your doctor is aware of your symptoms so they can evaluate you for arthritis and recommend treatment.
Bursitis is a painful inflammation of the bursae—small, fluid-filled sacs that cushion the joint from the bones, tendons, and muscles surrounding it. As with arthritis, a joint affected by bursitis is likely to feel achy or stiff. It may hurt more if you move it or press on it, and it may appear swollen or red. The risk increases with advancing age and increased weight.
Unlike arthritis, which advances slowly and over time, bursitis often develops in a joint overuse, especially by repetitive movements. Symptoms can arise out of daily activities like raking, cooking, or typing at a computer, or by sustained pressure on a joint. The bursae over the kneecap, for example, can become inflamed if subjected to pressure for long periods, as when kneeling in a garden or scrubbing a floor. (Stanford Health, 2021)
Bursitis may be the cause if you experience any of the following:
- Any new pain, aches, or stiffness in your joints
- Pain during or after engaging in activities that require repetitive movements
- A recent blow to the hip, knee, or elbow
Bursitis usually improves over time and without much intervention aside from rest, ice, and an over-the-counter pain reliever. Gently moving the affected joint to keep it limber may also promote healing. If the pain persists, your doctor may recommend physical therapy or a corticosteroid injection to relieve the inflammation. Your doctor may also drain the inflamed bursa to decrease the pressure on your joint.
See your doctor right away if your pain is accompanied by fever or if you experience the following:
- Severe or disabling joint pain
- Sudden inability to move a joint
- Excessive swelling, redness, bruising, or a rash in the affected area
- Sharp or shooting pain, especially during exertion (Stanford Health, 2021)
“Arthritis.” Mayo Clinic, 2020. https://www.mayoclinic.org/diseases-conditions/arthritis/symptoms-causes/syc-20350772
“Bursitis.” Mayo Clinic, 2020. https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242
“Bursitis.” Stanford Health Care, 2021. https://stanfordhealthcare.org/medical-conditions/bones-joints-and-muscles/bursitis/symptoms.html
Silver, N. “Bursitis vs. Arthritis: What’s the Difference?” Healthline. April 24, 2020. https://www.healthline.com/health/osteoarthritis/bursitis-vs-arthritis#symptom-comparison