A bursa is a small, fluid-filled sac located near major joints. These structures act as a natural cushion, providing a gliding surface between bones and adjacent soft tissues like tendons and muscles. When a bursa becomes severely damaged or chronically inflamed, it causes ongoing pain and limited mobility. This raises the question of whether this cushion can, and should, be surgically removed.
Understanding the Bursa’s Role
The human body contains over 150 bursae, functioning primarily to minimize friction during movement. Each bursa is lined by a synovial membrane that secretes synovial fluid, a viscous liquid that acts as a lubricant. This fluid allows tendons and muscles to slide smoothly over bony prominences as a joint moves. The bursa prevents the constant rubbing of soft tissue directly against bone, which would otherwise cause rapid wear and tear and severe discomfort.
When Removal Becomes Necessary
The surgical removal of a bursa, known as a bursectomy, is considered a last resort after conservative treatments have failed. This intervention is reserved for chronic inflammation (bursitis) that persists despite non-surgical management. Conservative approaches include rest, anti-inflammatory medications, physical therapy, injections, or fluid aspiration.
A bursectomy is often indicated when the bursa has become permanently thickened, scarred, or calcified. The procedure is also necessary for treating septic bursitis, an infection within the sac that does not clear with antibiotics and drainage alone. Removing the infected tissue eliminates the source of persistent bacterial contamination.
The decision to proceed with surgery is made when the inflamed bursa severely restricts range of motion or causes recurring, debilitating pain. In these situations, the damaged bursa has become a liability, and its removal offers the best path toward restoring joint comfort and function.
The Surgical Procedure and Recovery
A bursectomy is typically performed using open surgery or a minimally invasive arthroscopic procedure. Open surgery involves a single, larger incision, often reserved for cases with extensive scarring or calcification. Arthroscopic surgery is preferred when possible, utilizing small incisions for a camera and specialized instruments to remove the inflamed tissue.
The procedure is usually performed as an outpatient surgery under general, regional, or local anesthesia. The operation generally takes between 30 minutes and two hours. Surgeons remove the inflamed sac while preserving the surrounding tendons and muscles necessary for joint movement.
Immediate recovery focuses on pain management using prescribed medications, ice, and elevation to minimize swelling. Patients are encouraged to begin gentle movement soon after the procedure to prevent joint stiffness. Most individuals return to light daily activities within a few days to two weeks, during which the surgical incisions typically heal.
Life After Bursectomy
The long-term outlook after a bursectomy is positive, as the body adapts well to the removal of the sac. In the space where the bursa was removed, the body naturally forms a new, functional bursa over time. This new structure is generally thinner and less prone to the chronic irritation that plagued the original bursa.
In some cases, the body forms a smooth, fibrous scar tissue surface that allows tendons and muscles to glide without excessive friction. Joint mobility is not compromised by the removal, and patients usually regain full function with a structured physical therapy plan. The risk of the problem recurring is significantly reduced once the problematic tissue is excised.
While acute recovery takes a few weeks, the full return to sports or heavy manual labor typically takes two to three months or longer. This extended period allows the new gliding surface to fully mature and the surrounding muscles to regain strength and endurance. Patients can expect a substantial and lasting improvement in comfort and joint function.