OhioHealth Online

Bursitis is a painful condition that affects the small fluid-filled pads — called bursae — that act as cushions among your bones and the tendons and muscles near your joints. Bursitis occurs when a bursa becomes inflamed.

The most common locations for bursitis are in the shoulders, elbows or hips. But you can also have bursitis by your knee, heel and the base of your big toe. Bursitis often occurs in joints that perform frequent repetitive motion.

Treatment typically involves resting the affected joint and protecting it from further trauma. In most cases, bursitis pain goes away within a few weeks with proper treatment, but recurrent flare-ups of bursitis are common.

If you have bursitis, the affected joint may:

• Feel achy or stiff
• Hurt more when you move it or press on it
• Look swollen and red

When to see a doctor
Consult your doctor if you have:

• Disabling joint pain
• Pain for more than two weeks
• Excessive swelling, redness, bruising or a rash in the affected area
• Sharp or shooting pain, especially when you exercise or exert yourself
• A fever

The most common causes of bursitis are repetitive motions or positions that irritate the bursae around a joint. Examples include:

• Throwing a baseball or lifting something over your head repeatedly
• Leaning on your elbows for long periods of time
• Extensive kneeling, for tasks such as laying carpet or scrubbing floors
• Prolonged sitting, particularly on hard surfaces

Some bursae at the knee and elbow lie just below the skin, so they are at higher risk of puncture injuries that can become infected and cause septic bursitis.

Age
The occurrence of bursitis becomes more common during middle age.

Occupations or hobbies
If you work in a profession or have a hobby that requires repetitive motion or pressure on particular bursae, you're at an increased risk of developing bursitis. Examples include:

• Carpet laying
• Tile setting
• Gardening
• Bicycling
• Baseball
• Ice skating

Other medical conditions
Certain diseases and conditions increase your risk of developing bursitis, such as:

• Rheumatoid arthritis
• Osteoarthritis
• Gout
• Thyroid disease
• Diabetes

While you may initially bring your concerns to your family physician, he or she may refer you to a doctor who specializes in joint disorders (rheumatologist).

What you can do
You may want to write a list that includes:

• Detailed descriptions of your symptoms
• Information about medical problems you've had
• Information about the medical problems of your parents or siblings
• All the medications and dietary supplements you take
• Questions you want to ask the doctor

What to expect from your doctor
During the physical exam, your doctor will press on various spots around your affected joint to try to determine whether a specific bursa is causing your pain.

Imaging tests
If it appears that something else may be causing the discomfort, your physician may request an X-ray of the affected area. If bursitis is the cause, X-ray images can't positively establish the diagnosis, but they can help to exclude other causes of your discomfort.

Lab tests
Although you usually can trace bursitis to events of overuse or pressure, there may be no obvious cause. In the latter case, your doctor may want to perform additional screening to rule out other causes of joint inflammation and pain. This may include blood tests or an analysis of fluid from the inflamed bursa.

Bursitis treatment is usually simple and includes:

• Resting and immobilizing the affected area
• Applying ice to reduce swelling
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others), to relieve pain and reduce inflammation

Sometimes, your doctor may recommend physical therapy or exercises to strengthen the muscles in the area. Additionally, your doctor may inject a corticosteroid drug into the bursa to relieve inflammation. This treatment generally brings rapid pain relief and, in many cases, one injection is all you'll need.

If your bursitis is caused by an infection, you'll need to take antibiotics. Sometimes the bursa must be surgically drained, but only rarely is surgical removal of the affected bursa necessary.

While not all types of bursitis can be prevented, you can reduce your risk and reduce the severity of flare-ups by changing the way you perform certain tasks. Examples include:

• Use kneeling pads. Use some type of padding to reduce the pressure on your knees if your job or hobby requires a lot of kneeling.
• Cushion your knees. If you sleep on your side, you may want to place a small pillow between your thighs to help keep your top knee from pressing on your bottom knee.
• Lift properly. Bend your knees when you lift. Failing to do so puts extra stress on the bursae in your hips.
• Avoid elbow pressure. Stop leaning on your elbows. If you push up from your elbows to get out of bed, consider tying a rope to the end of your bed so that you can pull yourself up that way.
• Wheel heavy loads. Carrying heavy loads puts stress on the bursae in your shoulders. Use a dolly or a wheeled cart instead.
• Take frequent breaks. Alternate repetitive tasks with rest or other activities.
• Walk around. Try not to sit in one position for too long, especially on hard surfaces, because that puts pressure on the bursae in your hips and buttocks.