Bursitis is the inflammation of a bursa, which is a small, fluid-filled sac that acts as a cushion and reduces friction between tissues such as bones, muscles, tendons, and skin. Bursae are found in joints throughout the body, and their function is to prevent wear and tear on the tissues that move across each other. When a bursa becomes irritated or inflamed, it causes pain, swelling, and limited movement in the affected area.
1. Causes of Bursitis
Bursitis can occur for various reasons, including:
- Repetitive motion or overuse: Activities that involve repetitive movements or constant pressure on a particular joint, such as in sports (e.g., tennis, baseball) or certain jobs (e.g., construction work), can lead to bursitis.
- Injury or trauma: A direct blow or injury to a joint can cause the bursa to become inflamed.
- Infection: In rare cases, a bursa can become infected, a condition known as septic bursitis, which is more common in people with weakened immune systems or those who have had joint surgery.
- Underlying health conditions: Conditions such as rheumatoid arthritis, gout, or diabetes can increase the risk of bursitis due to their effects on the joints.
- Age: Older adults are more likely to develop bursitis because of natural wear and tear on the joints over time.
2. Symptoms of Bursitis
The most common symptoms of bursitis include:
- Pain: A dull or sharp pain that worsens with movement or pressure on the affected joint. The pain can be localized to a specific area and may worsen with activities that involve repetitive motion.
- Swelling: The affected area may appear swollen due to the accumulation of fluid in the bursa.
- Redness and warmth: The skin around the inflamed bursa may become red and feel warm to the touch, particularly if the bursitis is caused by infection.
- Limited range of motion: Bursitis can make it difficult or painful to move the joint normally, which can impact daily activities.
- Tenderness: The area over the bursa may be tender when pressed.
3. Common Areas Affected by Bursitis
- Shoulder: Subacromial bursitis, often caused by repetitive overhead motions, is a common type of shoulder bursitis.
- Elbow: Olecranon bursitis (also called "student's elbow") affects the bursa at the tip of the elbow.
- Hip: Trochanteric bursitis causes pain on the outer part of the hip and is commonly associated with activities like running or cycling.
- Knee: Prepatellar bursitis (also called "housemaid's knee") affects the bursa in front of the kneecap and is often caused by prolonged kneeling.
- Heel: Retrocalcaneal bursitis affects the bursa at the back of the heel and can be associated with repetitive stress from running or improper footwear.
4. Diagnosis of Bursitis
A healthcare provider will typically diagnose bursitis based on:
- Medical history and symptoms: The provider will ask about activities, symptoms, and any recent injuries or overuse.
- Physical examination: The affected area will be examined for swelling, tenderness, and limited range of motion.
- Imaging tests: X-rays can help rule out other conditions like fractures or arthritis, while ultrasound or MRI scans can provide detailed images of the bursa and surrounding tissues to confirm the diagnosis.
- Aspiration and lab tests: In cases where infection is suspected, a healthcare provider may use a needle to withdraw fluid from the bursa (aspiration) to check for signs of infection or crystals (as in gout).
5. Treatment for Bursitis
Treatment for bursitis depends on the severity and cause of the inflammation but typically includes:
A. Conservative (Non-Surgical) Treatment
- Rest: Avoid activities that aggravate the pain, particularly those involving repetitive movement or pressure on the affected joint.
- Ice: Applying ice packs to the inflamed area can help reduce swelling and pain. Typically, ice should be applied for 15-20 minutes at a time, several times a day.
- Medications:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen can help reduce pain and inflammation.
- Corticosteroid injections may be used to reduce inflammation in more severe cases.
- Physical therapy: Exercises to strengthen the muscles around the joint can improve mobility and prevent further injury or irritation to the bursa.
- Elevation: Elevating the affected limb can help reduce swelling, particularly in the case of bursitis in the lower body (e.g., knee or ankle).
- Compression: Using an elastic bandage or brace can help reduce swelling, especially in the case of knee or elbow bursitis.
B. Treatment for Infectious Bursitis
If bursitis is caused by infection (septic bursitis), the treatment will include:
- Antibiotics: Oral or intravenous antibiotics are prescribed to treat the infection.
- Aspiration or drainage: In some cases, the fluid from the infected bursa may need to be drained using a needle or through a small incision.
- Surgical intervention: In severe cases of septic bursitis, surgery may be required to remove the infected bursa or to clean the joint.
C. Surgical Treatment
Surgery is usually a last resort if:
- The bursitis does not respond to other treatments.
- The bursa becomes chronically inflamed or the condition worsens.
- There is persistent or recurrent infection despite antibiotics.
In these cases, a bursectomy, or removal of the affected bursa, may be recommended.
6. Prevention of Bursitis
To prevent bursitis or reduce the risk of flare-ups:
- Warm up and stretch before engaging in physical activity to prepare the muscles and joints.
- Take breaks during repetitive tasks to rest the joints and reduce stress on the bursae.
- Use proper body mechanics: When lifting or performing physical activities, ensure you are using correct posture and techniques to avoid joint strain.
- Wear proper footwear: Supportive shoes can help reduce the risk of hip, knee, and foot bursitis, especially during exercise or work activities.
- Maintain a healthy weight: Excess weight can put added stress on joints, increasing the risk of bursitis, especially in weight-bearing joints like the hips and knees.
- Strengthen muscles around the joints to improve stability and reduce the risk of injury to the bursa.
7. When to See a Doctor
You should see a doctor if:
- You experience persistent joint pain, swelling, or tenderness.
- The pain worsens or doesn't improve with rest and over-the-counter treatments.
- There is redness, warmth, or fever, which could indicate infection.
- You experience significant difficulty moving the joint.
