Bursitis is a common condition that develops when the small, fluid-filled sacs near your joints become irritated and swell. These sacs, known as bursae, function like tiny cushions, reducing friction between bones, tendons, and muscles to facilitate smooth movement. While bursitis often responds well to simple, early interventions like rest and ice, ignoring the condition can set off a chain reaction of escalating complications. Leaving bursitis untreated shifts the problem from a temporary, localized inflammation to a more serious issue that can permanently affect joint health and function.
Escalating Pain and Restricted Movement
Untreated inflammation in the bursa gradually transforms the pain, moving from intermittent, acute flare-ups to persistent, chronic discomfort. The body’s attempt to heal the irritated bursa causes a buildup of fluid and pressure, which constantly irritates surrounding nerves and tissues. This steady pain often forces a person to guard the affected joint, leading to a functional decline.
The persistent swelling physically limits the space available for tendons and muscles to glide smoothly over the bone. This restriction directly reduces the joint’s range of motion. Simple daily activities become difficult, such as lifting an arm above the shoulder, kneeling, or walking normally, because movement compresses the swollen sac. This decline further weakens surrounding muscles, creating a cycle of pain, disuse, and reduced physical capability.
Structural Changes and Tissue Damage
Allowing bursitis to persist beyond the acute phase can trigger long-term physical changes within the joint structure. One consequence is the chronic thickening of the bursal lining, a process known as fibrosis. The bursa’s inner lining becomes scarred and less pliable, which physically restricts movement even after the initial swelling has subsided.
Chronic inflammation can also promote the deposition of calcium salts within the bursa or nearby tendons, resulting in calcification. These hardened deposits impede smooth joint movement and act as a constant source of mechanical irritation and pain. Additionally, prolonged inflammation encourages the formation of adhesions, which are bands of scar tissue that physically bind the bursa to surrounding tendons and muscles. These adhesions can make movement permanently restricted and painful.
Risk of Septic Bursitis
The most severe complication of neglected bursitis is the development of septic bursitis, an infection of the bursa caused by bacteria. While most cases of bursitis are non-infectious (aseptic), the location of many bursae—such as those in the elbow and knee—just beneath the skin makes them vulnerable. An untreated, swollen bursa is more susceptible to bacterial invasion, often from a minor cut, scrape, or abrasion in the overlying skin.
Once bacteria enter the fluid-filled sac, they multiply rapidly, turning the bursal fluid into pus and creating an abscess. Unlike non-septic bursitis, this condition is a medical emergency that can rapidly spread the infection beyond the joint. Signs of septic bursitis include localized redness and intense warmth, along with systemic symptoms such as fever and chills. Immediate treatment with targeted antibiotics is necessary to prevent the infection from spreading into the bloodstream, a potentially life-threatening condition.
Advanced Interventions Required
When bursitis is left untreated and progresses to a chronic or complicated state, medical interventions become more invasive than early-stage care. In cases of persistent swelling that does not respond to anti-inflammatory medications, the joint may require repeated aspiration. This procedure involves inserting a needle to drain the excess fluid from the bursa, which relieves pressure.
If the bursitis is chronic, recurs frequently, or has become severely septic, a more drastic surgical procedure may be required. This surgery is called a bursectomy, which involves the complete removal of the inflamed bursa sac. While the bursa is not structurally essential, this procedure is only considered when less invasive methods have failed to resolve the problem.