Bursitis

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Introduction

What is bursitis?

Bursitis is the inflammation of a fluid-filled sac around a joint. The bursa helps tendons slide smoothly over and around bones, and when it is inflamed (bursitis), you may experience pain, swelling and stiffness in the affected joint.

Bursitis most commonly occurs in the knees, elbows, shoulders, and hips. Bursitis can develop acutely or can be a chronic condition that comes and goes over a long period of time. Bursitis can be caused by trauma to a joint, the overuse of a joint, or medical conditions such as arthritis or gout. Bursitis is most common in middle-aged individuals.

Bursitis can affect anyone, but people who use a specific joint a great deal, such as the way a tennis player uses his or her elbow, and older people who have arthritis or gout are at the most risk. Bursitis is not a life-threatening condition, but it can severely impair mobility in the affected joint.

Seek prompt medical care if you are being treated for bursitis but joint symptoms recur or are persistent.

Symptoms

What are the symptoms of bursitis?

Symptoms of bursitis include pain and swelling around a joint as well as limited motion. Symptoms can be severe and may come and go with activity or for no apparent reason.

Common symptoms of bursitis

You may experience bursitis symptoms daily or just once in a while. At times, any of these bursitis symptoms can be severe:

  • Dull ache or feeling of stiffness in the joint
  • Joint pain, especially with motion
  • Redness around the joint
  • Reduced mobility (range of motion of the joint)
  • Swelling around the joint
  • Visible deformity of the affected joint

Symptoms that might indicate a serious condition

In some cases, bursitis can accompany a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms:

  • Absent or diminished pulses
  • Change in level of consciousness or alertness, such as passing out or unresponsiveness
  • Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions
  • High fever (higher than 101 degrees Fahrenheit)
  • Infection or wound in close proximity to a joint
  • Numbness or tingling in the foot or hand beyond the affected joint
Causes

What causes bursitis?

Anything that inflames the fluid-filled bursa can cause bursitis. The most common causes of bursitis are overuse and trauma, as might occur if, for example, you spend an entire day on your knees doing yard work. Other common causes include such medical conditions as arthritis or gout, which can lead to inflammation of the bursa as well. In rare instances, a bacterial infection can cause bursitis.

Causes of bursitis

Common causes of bursitis include:

  • Gout (type of arthritis caused by a buildup of uric acid in the joints)
  • Infections
  • Intermittent, vigorous physical activity (“weekend warriors”)
  • Other arthritis-related conditions
  • Overuse of a joint
  • Rheumatoid arthritis (chronic autoimmune disease characterized by joint inflammation)
  • Trauma or injury

What are the risk factors for bursitis?

A number of factors increase the risk of developing bursitis. Not all people with risk factors will get bursitis. Risk factors for bursitis include:

  • Arthritis
  • Participation in sports
  • Working in awkward positions, such as doing yard work or tile installation on your hands and knees
Treatments

How is bursitis treated?

Bursitis has relatively few complications, but it can limit your mobility. Therefore, treatment is important so as not to restrict your activity. Bursitis can disappear on its own, but will often respond well to anti-inflammatory medications and a little rest. More severe cases and chronic cases of bursitis may require steroid injections. Symptoms may recur at a later time after successful treatment.

Common treatments for bursitis

Most cases of bursitis can be treated simply with rest, ice, and anti-inflammatory medications. The most simple and most common bursitis treatments include:

  • Icing the joint is an important and common treatment that will help reduce swelling and may reduce some of the pain

  • Nonsteroidal anti-inflammatory medications like ibuprofen (Advil, Motrin) can reduce pain and decrease swelling. These types of medications treat the symptoms and reduce the inflammation that is the underlying cause of the condition.

  • Physical therapy can be an important treatment for bursitis, as increased strength and flexibility around a joint can help to prevent bursitis from recurring

  • Rest is almost always necessary, as the bursa can heal only if it is free from additional movement that could further inflame it

Treatment for rare causes of bursitis or more severe cases

Uncommon causes of bursitis, such as a bacterial infection of the bursa, require special treatment. Severe cases of bursitis, as well as chronic cases, may also require special treatment. Special treatments include:

  • Corticosteroid injections may reduce inflammation in the bursa and are often given in conjunction with drainage of excess fluid from the bursa

  • Drainage of excess fluid in the bursa by needle, which may eliminate the pain and help the bursa to heal more quickly

  • Infections causing bursitis are treated by drainage of the bursa, performed by a heath care provider using a needle and antibiotics. The specific antibiotic used will depend on the type of infection causing the bursitis.

  • Surgery may be required in rare cases of severe bursitis or in chronic bursitis, especially when a bone projection is inducing inflammation in the affected region

What you can do to improve your bursitis

You can often treat mild bursitis. Anti-inflammatory medications, icing, and limiting the use of your joint until the pain subsides can eliminate the bursitis.

What are the potential complications of bursitis?

Bursitis does not usually result in serious complications. Serious bursitis and chronic bursitis can have some rare complications. The most common complication of bursitis, especially when not treated promptly, is recurrence.

You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of bursitis include:

  • Chronic pain in the affected joint

  • Injury or brittleness of the tendons resulting from steroid injections

  • Limited motion in the affected joint

  • Severe infection

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 2
  1. Bursitis. PubMed Health, a service of the NLM from the NIH. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001456/
  2. Prepatellar (kneecap ) bursitis. AAOS: American Academy of Orthopaedic Surgeons. http://orthoinfo.aaos.org/topic.cfm?topic=a00338
  3. Bope ET, Kellerman RD (Eds.) Conn’s Current Therapy. Philadelphia: Saunders, 2013.
  4. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins, 2013.
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