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Bursitis is a painful swelling that occurs in a tiny, fluid-filled sac known as a bursa. Bursa or bursae are tissues that cushion areas around bones and other tissue. They fill the gaps between bones and the muscles, tendons and skin. The inflammation of bursa is commonly caused by overusing and exerting too much pressure on it.
The body has more than 150 bursae. Any of them can be affected by bursitis. Bursitis is most prone to develop in joints used for repetitive motions or in regions where one exert a lot of pressure such as the shoulders, elbow, knees, hip, feet, and butt. Pain arising from an inflamed bursa can manifest either abruptly or gradually intensify over a period.
Bursitis pain usually resolves within a few weeks with proper treatment, although repeated bursitis flare-ups are common. The longer the pressure or stress is applied to an injured bursa, the longer it will take to heal. It also raises the risk of developing chronic bursitis. Resting and protecting the afflicted joint from further injury are the common treatments of this condition.
Symptoms
Bursitis has the following signs and symptoms:
- Pain, or stiffness, especially when moving affected region of the body
- Swollen and red
- Restricted range of motion
- Hurts more when moved or pressed on
If any of the signs and symptoms persist, consult a doctor for proper diagnosis especially when the pain is interfering with daily activities, and the soreness does not improve with home treatments.
Immediate consultation is also necessary when one has a fever, discoloration, or redness, swelling, or a heated sensation in an injured area, or unexpected inability to move a joint. Proper diagnosis and immediate treatment are necessary to prevent recurrence and long-term complications.
Causes
Bursitis has a variety of causes. This includes repetitive activities or spending time in positions that apply strain on a specific part of the body. Injury or trauma to the affected area, inflammatory arthritis such as rheumatoid arthritis, gout, and infection also cause bursitis.
Repetitive motions, positions, or activities that can cause bursitis include:
- Pitching a baseball
- Lifting heavy boxes at work
- Long periods of leaning on the elbows
- Carpentry
- Raking and gardening
- Painting
- Poor posture or a misaligned joint or bone due to differing leg lengths, bone spurs, or arthritis
- Scrubbing
- Shoveling
Risk factors
Several factors may contribute to increasing one’s risk of acquiring bursitis, such as:
- Age: The older the person, the risk of developing bursitis.
- Work or hobbies: Athletes, musicians, and people who do physical work, such as carpet installation, tile installation, gardening, and painting are at a higher risk of bursitis. The likelihood of getting bursitis increases if the job or pastime requires repetitive motion or pressure on certain bursae.
- Other medical conditions: Overweight people are more likely to develop hip and knee bursitis. It is also more likely to occur if one has certain systemic diseases and conditions, such as rheumatoid arthritis, gout, or diabetes.
Diagnosis
The diagnosis of bursitis often requires assessment of medical history and conduct of a physical exam. A physical exam involves evaluation of symptoms and inspection of the area surrounding the damaged body part. Patients may need to tell the doctor what they were doing before they felt symptoms for the first time, as well as the profession or pastime where they need to perform repeated motions.
- Imaging tests: If the bursitis cannot be identified with a physical exam alone. X-ray images cannot definitively rule out bursitis, but they can help rule out other possible reasons of the symptoms. Swollen bursae can be detected with ultrasound or MRI.
- Lab tests: A blood test may be necessary to detect infection. If the doctors believe that the affected bursa is infected, they will need to conduct an aspiration.
Treatment
Most cases of bursitis heal on their own with rest and at-home therapies. Rest is usually all that is required to treat bursitis. Avoid the activities or positions that caused the bursa to irritate. Stopping activities that exert pressure on that region of the body will allow it to heal and prevent further damage. Conservative methods such as heat or ice, elevating the affected region, and pain relievers can help alleviate discomfort.
Other treatment options may include:
- Medication: Antibiotics may be prescribed in cases of infection. The doctor will check if the swelling is caused by an infection.
- Injections: This medication usually works rapidly. Injection of corticosteroids into the bursa is utilized to reduce inflammation and pain. In most cases, only one injection is required.
- Therapy: Physical therapy can help improve one’s range of motion. It can be used to strengthen the muscles in the affected area, relieve discomfort, and avoid recurrence. Occupational therapy may be used to teach patients how to move in ways that do not strain the area.
- Assistive technology: Wearing a splint, sling, or brace to support the injured area. Using a walking cane or other device to reduce pressure on the affected area may be recommended.
- Surgery: If various therapies are ineffective and patients have been experiencing problems for six months or more, surgery to remove the bursa may be necessary. In some cases, an inflamed bursa may need to be surgically drained.
