This information with help you understand bursitis, including causes, diagnosis, and treatment.
Your bursae are small fluid-filled pads that act as cushions among your bones, tendons, and the muscles near your joints (see Figure 1). There are over 150 bursae in your body. When a bursa swells, you get a painful condition called bursitis. Bursitis most often develops in the shoulder, elbow, hip, and knee.
There are many causes of bursitis, including:
Figure 1: Bursitis
- Wearing tight-fitting shoes
- Kneeling, sitting, or lying on your side for long periods
- Stressing or overusing a joint by bicycling, running, playing tennis, throwing a ball many times, or carrying heavy objects
- Injuries, especially falls
- Poor posture
- Irritation of a bursa from:
- Joint surgery or surgically implanted hardware
- Bone spurs or calcium deposits on tendons
- Other medical conditions including gout, diabetes, rheumatoid arthritis, and thyroid disease
Common symptoms of bursitis include:
- Pain, stiffness, swelling, or discomfort around your elbow, hip, knee, shoulder, or other joints. You may feel this while your moving or at rest.
- Loss of movement due to pain and inflammation.
Your doctor can usually make a diagnosis based on your symptoms and a physical exam. He or she may order blood work and x-rays to rule out other possible problems. If there are signs of infection, you may need to have a biopsy. A biopsy involves removing a small amount of bursa fluid with a needle.
Your treatment may include rest, medications, ice or heat, occupational or physical therapy, steroid injections, or fluid aspiration (draining). Your healthcare team will make treatment recommendations based on your symptoms.
The goal of treatment is to:
- Reduce pain and inflammation.
- Maintain the use of your joint.
- Help prevent bursitis from coming back.
Rest your joints and avoid activities that cause pain and worsen your symptoms.
Your doctor may recommend that you take nonsteroidal anti-inflammatory drugs (NSAIDs). Some of these you can buy over-the-counter and for others you will need a prescription. Some examples of NSAIDs include:
- Ibuprofen (Advil®, Motrin®)
- Celecoxib (Celebrex®)
- Naproxen (Aleve®, Naprosyn®)
- Diclofenac (Voltaren®)
NSAIDs may have side effects. Talk to your doctor before taking NSAIDs.
Ice or heat
Your doctor or nurse may tell you to ice or heat your joints. Apply ice or heat for 20 minutes every 4 to 6 hours.
If using heat, you should fill a water bottle with warm, not hot water, or use a heating pad. Apply the heat to your joints for 20 minutes at a time. Do not leave it on for longer than 20 minutes.
Your doctor may refer you to an occupational or physical therapist. Your therapist will:
- Show you exercises to strengthen your joints.
- Tell you how to protect your joints, which will promote healing and help prevent bursitis from coming back.
- Provide an ultrasound, massage, or other therapies.
Steroid injections and fluid aspiration
If your symptoms continue or get worse, your doctor may inject a steroid into the area surrounding your joint. This will help to decrease inflammation and pain.
Your doctor may also aspirate (drain) the fluid in your joint, using a needle and syringe. This will help to relieve pain.