Topic Overview

The skeletal system

What is bursitis?

Bursitis is a painful swelling
of a small sac of fluid called a bursa. Bursae (plural of bursa) cushion and
lubricate areas where tendons, ligaments, skin, muscles, or bones rub against
each other. People who repeat the same movement over and over or who put
continued pressure on a joint in their jobs, sports, or daily activities have a
greater chance of getting bursitis.

What causes bursitis?

Bursitis is commonly caused
by:

  • Overuse and repeated movements. These can
    include daily activities such as using tools, gardening, cooking, cleaning, and
    typing at a keyboard.
  • Long periods of pressure on an area. For
    example, carpet layers, roofers, or gardeners who work on their knees all day
    can develop bursitis over the kneecap.
  • Aging, which can cause the
    bursa to break down over time.
  • Sudden injury, such as a blow to
    the elbow.

Bursitis can also be caused by other problems, such as
arthritis or infection (septic bursitis).

What are the symptoms?

Bursitis usually causes a
dull pain, tenderness, and stiffness near the affected bursa. The bursa may
swell and make the skin around it red and warm to the touch.

Bursitis is most common in the shoulder, elbow, hip, and knee. Bursitis may
also occur near the Achilles tendon or in the foot.

Symptoms of
bursitis may be like those of
tendinopathy. Both occur in the tissues in and
around the joints.

Check with your doctor if your pain is severe, if the sore area becomes
very hot or red, or if you have a fever.

How is bursitis diagnosed?

Your doctor will check
for bursitis by asking questions about your past health and recent activities
and by examining the area.

If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa through
a needle (aspiration) and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.

How is it treated?

Home treatment is often enough
to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen
the muscles around your joints.

  • Rest the affected area. Avoid any activity or direct pressure that may cause pain.
  • Apply ice or
    cold packs as soon as you notice pain in your muscles or near
    a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for
    3 days (72 hours). You can try heat, or alternating heat and ice, after the first 72 hours.
  • Use pain relievers. Use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and inflammation. NSAIDs come in pills and also in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain. Don’t rely on medicine to relieve pain so that you can keep overusing the joint.
  • Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move the joint
    through its full range of motion, even during the time that you are resting the
    joint area. This will prevent stiffness. As the pain goes away,
    add other exercises to
    strengthen the muscles around your joint.
  • Avoid tobacco smoke. Smoking delays wound
    and tissue healing.

If you have severe bursitis, your
doctor may use a needle to remove extra fluid from the bursa. You might wear
a pressure bandage on the area. Your doctor may also give you a shot of medicine to reduce swelling. Some
people need surgery to drain or remove the bursa.

Sometimes the
fluid in the bursa can get infected. If this happens, you may need
antibiotics.

Bursitis is likely to improve in a few days or weeks
if you rest and treat the affected area. But it may
return if you don’t stretch and strengthen the muscles around the joint and
change the way you do some activities.

How can you prevent bursitis?

You may be able to
prevent bursitis from happening or coming back.

  • Continue your home treatment with rest, ice, pain relievers, and gentle exercises.
  • When you are ready to try the activity that caused the pain, start slowly and do it for short periods or at a slower speed. Warm up before and stretch after the
    activity. Increase your activity slowly, and stop if it hurts. Use ice afterward to prevent pain and swelling.
  • Change the way you do activities with repeated movements
    that may strain your muscles or joints. For example:

    • If using a certain tool has caused bursitis, start switching hands or change the grip size of your tool.
    • If sitting for long periods has caused bursitis, get up and walk around every hour.
    • If a certain sport is causing bursitis,
      consider taking lessons to learn proper techniques. Have an expert check your equipment to make sure it’s well suited to your size, strength, and ability.
    • If certain activities at
      work may be causing bursitis, talk to your human resources department
      about other ways of doing your job, equipment changes,
      or other job assignments.
  • Protect your joints from
    pressure. Cushion knees or elbows on hard surfaces, and wear shoes that fit you well and have good support.

Other Places To Get Help

Organizations

American Academy of Orthopaedic Surgeons
www.orthoinfo.aaos.org

American College of Rheumatology
www.rheumatology.org

References

Other Works Consulted

  • Colburn KK (2015). Bursitis, tendinitis, myofascial pain, and fibromyalgia. In ET Bope, RD Kellerman, eds., Conn’s Current Therapy 2015, pp. 597-600. Philadelphia: Saunders.
  • McMahon PJ, et al. (2014). Sports medicine. In HB Skinner, PJ McMahon, eds., Current Diagnosis and Treatment in Orthopedics, 5th ed., pp. 88-155. New York: McGraw-Hill.

Credits

ByHealthwise Staff
Primary Medical Reviewer William H. Blahd, Jr., MD, FACEP – Emergency Medicine
Adam Husney, MD – Family Medicine
E. Gregory Thompson, MD – Internal Medicine
Specialist Medical Reviewer Kenneth J. Koval, MD – Orthopedic Surgery, Orthopedic Trauma

Current as ofMarch 21, 2017