Bursitis

If you perform repetitive motions in your work or sport and are experiencing joint pain and swelling, you could have bursitis. Other risk factors for developing bursitis include injury, infection, or arthritis in the affected joint—or being overweight.

What is Bursitis?

Bursitis is the inflammation of the bursae, fluid-filled sacs that cushion the muscles, bones, and tendons surrounding joints like shoulders, elbows, hips, and knees. These sacs create a gliding surface to minimize friction between tissues of the body. When they are swollen it hurts—but the good news is that with treatment the pain usually subsides within a few weeks.

Types of bursitis include:

• Anterior Achilles tendon bursitis is also called Albert’s disease or retromalleolar bursitis. Factors like injury, disease, or shoes with rigid back support put extra strain on the lower part of the Achilles tendon and can cause inflammation of the bursae located where the tendon attaches to the heel.
• Elbow bursitis is caused by injury or prolonged pressure on the elbow.
• Hip bursitis is caused by arthritis, injury, overuse, or surgery; it’s more common in women and aging adults.
• Knee bursitis is also known as trochanteric bursitis or Pes Anserine bursitis. It is caused by swelling of the Pes Anserine bursa located on the inside of the knee between the shin bone and the three hamstring tendons. This type of bursitis can be caused by improper or inadequate stretching before exercise, hamstring tightness, being overweight, and arthritis.
• Kneecap bursitis is also called prepatellar bursitis. It typically affects people whose professions require them to work on their knees, like carpet layers and plumbers.
• Posterior Achilles tendon bursitis or Haglund deformity is caused primarily by walking in shoes that place sustained pressure on the heel, leading to inflammation.

Bursitis Symptoms

The joints you use for repetitive motions—your hip, shoulder, and elbow—are the most susceptible to bursitis. But bursitis also can affect knee, heel, and the base of your big toe. A joint afflicted with bursitis might cause any of the following symptoms, which can be different from person to person:

• Pain
• Limited range of motion
• Swelling
• Redness if the inflamed bursa is close to the surface of the skin

Bursitis symptoms may mimic other health issues. If you experience symptoms, be sure to see a doctor.

Diagnosing & Treating Bursitis

Your doctor may be able to diagnose bursitis with just a physical exam and a review of your medical history, but may also use the following tests:

• Aspiration of fluid from the swollen bursa(e) to check for infection or gout
• X-ray
• Laboratory tests (bloodwork)
• MRI scan
• Ultrasound to look at tissue

Once identified, many types of bursitis can be treated—and future flare-ups can be minimized—by making some adjustments to how you perform frequent tasks. If you have septic bursitis, which is an infection in your bursa(e), you may need aspiration of the infected fluid in addition to rest of the joint, ice-and-heat application, and physical therapy. If these measures aren’t curative, surgical removal of the infected bursa (bursectomy) may be indicated.

If you have aseptic bursitis without infection your care team may introduce you to ergonomic adjustments, modified lifting techniques, weight-loss strategies, exercises, and other tactics for reducing your pain and flare-up risk. Other treatments might include:

• NSAIDs (non-steroidal anti-inflammatory medications)
• R.I.C.E. (rest, ice, compression, and elevation)
• Splints or braces to limit movement of the affected joint
• Corticosteroid injection to reduce joint pain and inflammation
• Draining of the bursae
• Bursectomy surgery (removal of the affected bursa) is rarely necessary but available as a last resort

What Are the Causes of Bursitis & Measures that Can Prevent It?

Commonly, bursitis is caused by injury and/or overuse. Infection may also cause it, and it can be linked to other health problems like arthritis, diabetes, gout, tendonitis, and thyroid disease.

To prevent it, you should implement the following measures in your lifestyle:

• Always introduce new exercises regimens slowly
• Warm up before exercising and sports, and stretch afterward
• Use elbow or knee pads
• When doing tasks using repetitive motions, take breaks frequently
• Practice good posture in everyday activities
• If you feel pain with certain activities, avoid them

When Should You Call Your Doctor?

Any of the following warrant a call to your doctor:

• Pain or stiffness that impacts your daily activities
• Joint inflammation or redness
• A lump in the affected joint
• Pain that doesn’t improve with treatment
• Fever, chills, or night sweats