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Bursitis

Definition

A bursa is a thin sac. It lies between bone and soft tissue near certain joints. A healthy bursa allows smooth movement of soft tissue over the bone. Bursitis is inflammation of a bursa. This inflammation can make it painful to move the nearby joint.
Bursitis occurs most often in the:
  • Shoulder
  • Elbow
  • Knee
  • Hip
Bursitis in the Shoulder
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Causes

Bursitis may be caused by:
  • A blow to an area containing a bursa
  • Repetitive stress on the bursa
  • Infection in bursa
  • Long periods of pressure on joint—leaning on elbows, sitting or kneeling on hard surfaces
  • Medical conditions that cause inflammation in joints such as rheumatoid arthritis or gout
If the stress is not relieved, bursitis can become chronic (long term) condition. This can make permanent changes of the bursa.

Risk Factors

Factors that increase your chance for bursitis include:
  • Repetitive motion activities when done to an extreme (for example, swimming, running, or tennis)
  • Job that requires:
    • Repetitive motions such as hammering or painting
    • Long hours in one position such as a carpenter kneeling
  • Contact sports
  • Sporting gear that is too tight
  • Puncture or deep cut that involves bursa

Symptoms

Symptoms of bursitis include:
  • Pain in the area
  • Swelling
  • Reddened skin
  • Warmth around the area of the bursa
  • Decreased motion of the nearby joint
  • Decreased function of the nearby limb

Diagnosis

The doctor will ask about your symptoms and your physical activities. The painful area will be examined. You may have an x-ray.

Treatment

Bursitis treatment will focus on decreasing the inflammation and pain. The main step is to stop the activity causing the pain. You will be asked to rest the area involved and protect it from trauma. Your doctor may also recommend:
  • Applying ice to the area in the first few days
  • Anti-inflammatory medications such as ibuprofen or naproxen
  • Crutches or cane if knee or hip bursitis needs support
If the bursitis is very painful, your doctor may recommend a corticosteroid injection. These injections have short-term benefits and some risk. They may be limited to conditions that interfere with daily activities.
Chronic bursitis may need more aggressive treatment. Additional steps may include:
  • Physical therapy—sessions may include exercises and heat therapy
  • Surgery—only if all other treatments are not effective

Prevention

The following steps may help to prevent bursitis:
  • Do not overdo sports and other activities.
  • When doing a new activity, gradually increase the intensity and duration of activity.
  • Make sure you perform activities correctly.
  • Wear properly fitting, protective pads if you play contact sports.
  • Use proper safety equipment at work.
  • Work with an ergonomic specialist to improve work related activities.

RESOURCES

American Academy of Orthopaedic Surgeons http://www.aaos.org

American Orthopaedic Society for Sports Medicine http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

References

Bursitis. Ohio State University Wexner Medical Center website. Available at: http://medicalcenter.osu.edu/patientcare/healthcare%5Fservices/spine%5Fshoulder%5Fpelvic%5Fdisorders/common%5Fdisorders%5Fspine%5Fsholder%5Fpelvis/bursitis/Pages/index.aspx. Accessed January 3, 2013.

Elbow bursitis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00028. Accessed January 3, 2013.

Hip bursitis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00409 . Accessed January 3, 2013.

Human Tendons: Anatomy, Physiology, and Pathology. Lippincott, Williams, and Wilkins; 1997.

Prepatellar bursitis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated September 5, 2012. Accessed January 3, 2013.

Revision Information

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.

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