Definition

Bursitis is inflammation of a bursa. A bursa is a thin sac that lies between bone and soft tissue. It can be found near some joints. A healthy bursa allows smooth movement of soft tissue over bone. If a bursa becomes inflamed it can make movement painful.

Bursitis occurs most often in the:

• Shoulder
• Elbow
• Knee
• Hip

Bursitis in the Shoulder

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Causes

Bursitis may be caused by:

• An injury to the 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

Risk Factors

Factors that may increase your chance of bursitis include:

• Repetitive motion activities when done to an extreme, such as swimming, running, or tennis
• A 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
• A puncture or deep cut that involves bursa

Symptoms

Bursitis may cause any of the following:

• 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

You will be asked about your symptoms. The doctor may also ask about your daily habits and any injuries. The painful area will be looked at carefully. The diagnosis is often made based on how the area looks and symptoms.

Treatment

Bursitis treatment will focus on decreasing inflammation and pain. The main step is to stop the activity causing the pain. You will be asked to rest the area and protect it from injury. Your doctor may also recommend:

• Applying ice to the area in the first few days
• Nonsteroidal anti-inflammatory drugs (NSAIDs) for inflammation and pain
• Crutches or a cane if knee or hip bursitis needs support

Most bursitis will clear up with basic care. However, it can become a long-term problem if the cause is not relieved. Options for chronic bursitis or bursitis that does not respond to steps above include:

Chronic bursitis may need more aggressive treatment. Additional steps may include:

• A corticosteroid injection
  • Often only offered for bursitis that is very painful and not responding to basic care.
  • Have short-term benefits and some risk. Talk to your doctor about benefits and risks for you.
• Physical therapy—sessions may include exercises and heat therapy
• Surgery—only if all other treatments are not effective

Prevention

To help reduce your chance of bursitis:

• Do not overdo sports and other activities.
• Do a gradual increase in the intensity and duration of your activity. This is very important when you start new sports.
• Use proper protective pads if you play contact sports.
• Use proper safety equipment at work.
• Work with an ergonomic specialist. They may be able to help decrease stress on joints. This works best in jobs with repetitive motion or long periods of pressure on the joints.