Bursitis

What is bursitis?

Bursitis is inflammation of a bursa. A bursa is a fluid-filled sac that surrounds joints or tendons. A bursa reduces friction by cushioning muscles or tendons and bones that move back and forth across each other. The elbow, hip, knee, shoulder, and other joints contain a cushioning bursa. Inflammation means that the bursa is swollen and painful.

How does it occur?

Irritation, injury, or pressure to a bursa can cause swelling and pain.

Causes of bursitis include:

• injury of a joint from sports activities, such as baseball, tennis, racquetball, and running
• frequent irritation of or friction on part of your body from other activities, including everyday household jobs such as yardwork, shoveling dirt or snow, and house painting
• kneeling on a hard or raised surface for long periods of time, causing prepatellar bursitis (also called housemaid's knee)
• repeated pressure on the point of the elbow—for example, by leaning on a table or desk for a long time—causing olecranon bursitis (nicknamed student's elbow).
• infection of a bursa--for example, from a cut or a scrape on the skin over the bursa (septic bursitis).

What are the symptoms?

Symptoms of bursitis are swelling, redness, and pain, usually near a joint.

How is it diagnosed?

Your healthcare provider will ask about your symptoms and medical history and examine you. He or she may use a needle and syringe to get a sample of fluid from the bursa. The fluid can be checked for infection and other causes of the bursitis. You may have X-rays and blood tests.

How is it treated?

To relieve symptoms of bursitis:

• Rest the joint that is hurting.
• Do not put any pressure on the sore area while it is swollen. For example, don’t kneel on a swollen knee.
• Put an ice pack on the area for 20 to 30 minutes 3 or 4 times a day to help relieve pain.
• Wear a compression wrap around the joint (such as the elbow or knee) while the bursa is swollen or after your healthcare provider drains the fluid.
• Take a nonprescription anti-inflammatory medicine, such as ibuprofen or naproxen, or a medicine prescribed by your healthcare provider. Nonsteroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. These risks increase with age. Read the label and take as directed. Unless recommended by your healthcare provider, do not take for more than 10 days for any reason.
• Do exercises to keep your range of motion and keep the joint from getting stiff.
• Do gentle exercises to help the joint get stronger.
• You may need to wait several days to several weeks before you can do the activity again that caused the problem.

Septic bursitis is treated with antibiotics.

If you keep having symptoms:

• Your healthcare provider may remove fluid from the swollen area with a needle and syringe. Your provider may then wrap the injured site or put a splint on it to keep fluid from refilling the area and to prevent you from moving it.
• Your provider may inject the inflamed area with a steroid drug (usually cortisone) and a local anesthetic so you will have less swelling, redness, and pain.
• Your provider may recommend surgery to take out the bursa if the joint keeps bothering you even after treatment.

How long will the effects last?

With treatment, the pain and swelling of bursitis usually goes away in 1 or 2 weeks. Even when the swelling goes away, the bursa may feel thicker for quite some time.

When should I call my healthcare provider?

Call your provider right away if you have these signs of possible infection:

• The swelling spreads despite treatment.
• You develop fever higher than 101.5° F (38.6° C) or chills.
• The painful area feels warmer.

How can I help prevent bursitis?

In some cases it may help to avoid doing whatever seems to have caused the bursitis. Try not to overuse or reinjure the area that was painful. Avoid pressure and injury to joints by wearing protective pads.