Both gout and bursitis are conditions which affect the joints, causing symptoms of pain and swelling. The similarity of their symptoms can make it difficult to distinguish the cause of your discomfort, especially if joint pain is new for you. Whilst you should always see a health professional to diagnose any condition you are suffering from, there are some key differences between gout and bursitis which are well worth knowing about.
Here are the main ways in which these two common conditions differ, and how you can help to reduce your chances of developing either of them.
Causes
Whilst both gout and bursitis impact the joints, they are caused by different problems and chemical processes within the body. Gout is a result of sharp urate crystals becoming lodged around the joints, which form as a result of having high levels of uric acid in the blood.
Bursitis happens when the bursa becomes inflamed or infected. The bursa is a small, fluid-filled sac which absorbs shock, cushions and lubricates the joints and their surrounding tissues. Having bursitis cannot cause gout, but having gout can lead to the bursa becoming irritated. Therefore, having gout is actually a risk factor for bursitis.
Risk factors
Some risk factors for developing these conditions are common, including being overweight and having pre-existing health concerns such as diabetes, or suffering from a joint-related injury.
Others are specific to each condition. For gout, the most prevalent risk factor is consuming a diet too high in alcohol, red meats, organs meats and shellfish. This is because these foods contain a high amount of purines, which cause uric acid to be produced when they are metabolised by the kidneys.
Risk factors for bursitis include overuse of a joint, which is why this condition is common in athletes, as well as construction workers or people who continuously use specific joints daily. Resting the sore joint and taking anti-inflammatory medication is one of the best ways to manage your symptoms of bursitis.
Symptoms
As both gout and bursitis cause severe pain, swelling and a reduced range of movement, one way to determine which of these conditions may be ailing you is to consider which joint it is that’s painful. Gout typically affects the joints of the extremities, usually the big toe and sometimes the fingers. In contrast, whilst bursitis can also affect these joints, it is most common in the elbows, knees and hips.
Complications
Both these conditions can lead to unpleasant compilations, so it’s important to know how to manage them.
Recurring gout can cause erosion of the cartilage in the joint, which is extremely painful. Advanced gout can also cause painful deposits of urate crystals to form under the skin, called tophi. Kidney stones are also a concern for people living with gout, which may need medical treatment. To manage your symptoms of gout and reduce your chances of experiencing flare-ups, be sure to adjust your diet to include plenty of low-purine foods, drink plenty of water and exercise regularly.
Septic bursitis is caused by an infection, and can happen as a result of injury to the joint. If your bursitis is infected, the joint will feel hot, be red and inflamed. You may also feel unwell and have a fever. This condition requires urgent medical treatment. Bunions are also an associated complication of bursitis, where the first joint of the big toe becomes chronically inflamed. Again, see your doctor if you develop symptoms of bunions.
Whichever joint-related condition you may be suffering from, always consult a registered health professional for diagnostic tests and to access any recommended treatments.
Author
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We are physiotherapists passionate about movement and rehabilitation, with a clear goal: helping people better understand their pain and return to an active, unrestricted life.
Through our practice and content, we share practical, science-based approaches to prevent injuries, relieve pain, and sustainably improve mobility. We believe that well-informed patients make better decisions and achieve better outcomes.
Richard Bouzaglou, B.Sc. PT
Physiotherapist | Co-Founder
An experienced professional, Richard is the co-founder of the AMS Medical and Rehabilitation Center, where he has played a key role since 2008. With a background in sports medicine and physiotherapy, he has developed strong clinical expertise, particularly working with elite athletes.
His practice is based on a comprehensive approach that integrates advanced manual therapy, functional rehabilitation, and personalized care. Committed to continuous education and mentoring students, he is known for his clinical rigor and his ability to build lasting, trust-based relationships with his patients.
Moshe Vazana
Physiotherapist
With over 15 years of experience, Moshe is recognized for his precise, evidence-based approach. A physiotherapy graduate with advanced training in several methodologies, including the McKenzie Method (MDT) and the Mulligan Concept, he specializes in treating musculoskeletal and spinal conditions.
His international background and commitment to excellence enable him to provide care that is tailored, effective, and sustainable. Passionate about knowledge sharing, he is also actively involved in training the next generation of physiotherapy professionals.
This information was hard to track down in that very few people are addressing these types of inflammation together. Running in circles with various types of inflammation in my body and seeing everybody but being treated by no one. Thank you so much for the information. Especially as it seems I have to be my own doctor LOL
My pleasure. Not easy to be in that situation. Best of luck!
Has it been found that autoimmunity plays a role in gout and genetic inheritencel
Yes, indeed, it has been.
How to tell if you have autoimmune problems
Needs to be confirmed with either your GP or rheumatologist after having done a battery of tests including blood tests.
Thanks for the tip on septic bursitis. I don’t have a spleen, get bursitis often, have an autoimmune condition, and I get occasional sepsis. It’s a helpful reminder.
Thank you so much, since I woke up today with new pain. I know I have pseudo gout, and might have uric acid gout, but never pain and swelling in my hips. Your article makes sense, and I suspect bursitis. I’ll call my doctor, but I know I’ll get a shrug and a “could be….” I have had to really push the medical system to finally get a diagnosis of gout, so I’m sure the doctor is not looking forward to another complaint of pain from me!
You are very welcome!
Confirmation that gout can set off a bursitis flare. What a painful combination I have had these past 2 weeks. An xray last year showed gout, I’m 76. Swimming helps keep me mobile. With having a non alcholic liver, I see that can be a contributer to gout. Although only 10 lbs to loose, it is time to adjust my diet. Thank you, Patricia
Thank you for your input and for sharing your experience.
I get a swelling on top of my knee it’s definitely a bursitis but my doctor thinks I’m a know it all . I have an elevated uric acid and according to my many doctors I have gout. I have never had gout in my big toes but I have bunions
There are many reasons for getting swelling in your knee. You should rule out any orthopedic reason first (osteoarthritis, small meniscus tear, recent small sprain,…). Did you get X-rays of your knee? You can see a physiotherapist to rule that out. If that’s ruled out you can see a rheumatologist to confirm the diagnosis of gout. Most commonly the big toe is the most common location for gout but it can manifest itself in any joint of the body.
I have neuropathy in my feet and have now been diagnosed with a burse in my right hip for which I had a steroid injection 2-3 days ago.
Are they linked?
No improvement yet so should I be patient or take it further?
Very painful!
Not directly linked. You should wait at least 1 week for the injection to take effect.
Indeed it is very painful!
Good luck.
I have been a gout sufferer for years, but have had it under control with daily course of allopurinol. For the last few days, my heel has been painful and has gotten worse each day. I’m very active and walk a lot.
Could this be gout in my heel? I have had bursitis in my hip and shoulder, so my original thought was that.
Hi, not a typical area to get gout, check with your doctor or physiotherapist, it might be a heel spur or the beginning of plantar fascitis.
I went to Urgent Care last night because of a red, swollen and extremely painful kneecap. It was x-rayed and bloods were taken however the x-ray didn’t show any useful info. The consultant pressed on and around my kneecap and said it was all at the front and top, very tender to the touch. He told me it was Bursitis and I’ve started to take Fluloxicillin. Somebody said the word gout in passing, as as I have repeated gout in my left big toe, plus that was also painful, I wonder if it could be gout in my kneecap? Will the antibiotics still be effective or should I try to get colchicine from my GP?
Hard to say without performing a physical exam. You should follow up with a rheumatologist to make sure.