Bursitis

Bursitis is inflammation of a bursa. A bursa is a soft, fluid-filled sac. It cushions the soft tissue around a bone. Bursitis often occurs in the bursas near the shoulders, elbows, knees, pelvis, hips, heel, and Achilles tendon.

SYMPTOMS

  • Pain and tenderness in the affected area. Sometimes, pain radiates into surrounding areas. Specifically, pain with movement.

  • Limited range of motion of the affected joint.

  • Sometimes, painless swelling of the bursa.

  • Fever (when infected).

CAUSES

  • Injury to a joint or bursa.

  • Overuse or strenuous exercise of a joint.

  • Gout (disease with inflamed joints).

  • Prolonged pressure on a joint containing bursas (resting on an elbow or kneeling).

  • Arthritis.

  • Acute or chronic infection.

  • Calcium deposits in shoulder tendons, with degeneration of the tendon.

RISK INCREASES WITH:

  • Vigorous, repeated, or sudden increase in athletic training or activity level.

  • Failure to warm-up properly.

  • Overstretching.

  • Improper exercise technique.

  • Playing sports on Astroturf.

PREVENTION

  • Avoid injuries or overuse of muscles.

  • Warm-up and cool down properly. Do this before and after physical activity.

  • Maintain proper conditioning:

  • Joint flexibility.

  • Muscle strength and endurance.

  • Cardiovascular fitness.

  • Learn and use proper technique.

  • Wear protective equipment.

PROGNOSIS

With proper treatment, symptoms often go away within 7 to 14 days.

RELATED COMPLICATIONS

  • Frequent recurrence of symptoms. This can result in a chronic, repetitive problem.

  • Joint stiffness.

  • Limited joint movement.

  • Infection of bursa.

  • Chronic inflammation or scarring of bursa.

TREATMENT

Treatment first involves protecting and resting the bursa and its joint. You may use ice or an elastic bandage to reduce inflammation. Anti-inflammatory medicines may help resolve the swelling. If symptoms persist despite treatment, a caregiver may withdraw fluid from the bursa. They might also consider a corticosteroid injection. Sometimes, bursitis will persist in spite of non-surgical treatment or will become infected. These cases may require removal (surgical excision) of the bursa.

MEDICATION

  • If pain medicine is needed, nonsteroidal anti-inflammatory medicines, such as aspirin and ibuprofen, or other minor pain relievers, such as acetaminophen, are often recommended.

  • Do not take pain medicine for 7 days before surgery.

  • Prescription pain relievers are usually only prescribed after surgery. Use only as directed and only as much as you need.

  • Ointments applied to the skin may be helpful.

  • Corticosteroid injections may be given. This is done to reduce inflammation in the bursa.

HEAT AND COLD:

  • Cold treatment (icing) relieves pain and reduces inflammation. Cold treatment should be applied for 10 to 15 minutes every 2 to 3 hours for inflammation and pain, and immediately after any activity that aggravates your symptoms. Use ice packs or an ice massage.

  • Heat treatment may be used prior to performing the stretching and strengthening activities prescribed by your caregiver, physical therapist, or athletic trainer. Use a heat pack or a warm soak.

SEEK MEDICAL CARE IF:

  • Symptoms get worse or do not improve in 2 weeks, despite treatment.

  • New, unexplained symptoms develop. (Drugs used in treatment may produce side effects.)