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by Leach RE

Bursitis

Definition

Bursitis is inflammation of a bursa. A bursa is a thin sac that lies between bone and soft tissue near certain joints. A healthy bursa allows smooth movement of soft tissue over bone. Inflammation can make it painful to move the nearby joint.
Bursitis occurs most often in the:
  • Shoulder
  • Elbow
  • Knee
  • Hip
Bursitis in the Shoulder
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Causes

Bursitis may be caused by:
  • A blow to an area containing a bursa
  • Repetitive stress on the bursa
  • Infection in bursa
  • Long periods of pressure on joint—leaning on elbows, sitting or kneeling on hard surfaces
  • Medical conditions that cause inflammation in joints such as rheumatoid arthritis or gout
If the stress is not relieved, bursitis can become a long-term condition.

Risk Factors

Factors that increase your chance for bursitis include:
  • Repetitive motion activities when done to an extreme, such as swimming, running, or tennis
  • A job that requires:
    • Repetitive motions such as hammering or painting
    • Long hours in one position such as a carpenter kneeling
  • Contact sports
  • Sporting gear that is too tight
  • A puncture or deep cut that involves bursa

Symptoms

Symptoms of bursitis include:
  • Pain in the area
  • Swelling
  • Reddened skin
  • Warmth around the area of the bursa
  • Decreased motion of the nearby joint
  • Decreased function of the nearby limb

Diagnosis

You will be asked about your symptoms and your physical activities. The painful area will be examined.
Images may be taken of your bodily structures. This can be done with x-rays.

Treatment

Bursitis treatment will focus on decreasing inflammation and pain. The main step is to stop the activity causing the pain. You will be asked to rest the area and protect it from injury. Your doctor may also recommend:
  • Applying ice to the area in the first few days
  • Anti-inflammatory medications such as ibuprofen or naproxen
  • Crutches or a cane if knee or hip bursitis needs support
If the bursitis is painful, your doctor may recommend a corticosteroid injection. These injections have short-term benefits and some risk. They may be limited to conditions that interfere with daily activities.
Chronic bursitis may need more aggressive treatment. Additional steps may include:
  • Physical therapy—sessions may include exercises and heat therapy
  • Surgery—only if all other treatments are not effective

Prevention

The following steps may help to prevent bursitis:
  • Do not overdo sports and other activities.
  • When doing a new activity, gradually increase the intensity and duration of activity.
  • Make sure you perform activities correctly.
  • Wear properly fitting, protective pads if you play contact sports.
  • Use proper safety equipment at work.
  • Work with an ergonomic specialist to improve work related activities.

RESOURCES

American Academy of Orthopaedic Surgeons
http://orthoinfo.aaos.org
American Orthopaedic Society for Sports Medicine
http://www.sportsmed.org

CANADIAN RESOURCES

Canadian Orthopaedic Association
http://www.coa-aco.org
Canadian Orthopaedic Foundation
http://www.canorth.org

References

Bursitis. Ohio State University Wexner Medical Center website. Available at: http://medicalcenter.osu.edu/patientcare/healthcare%5Fservices/spine%5Fshoulder%5Fpelvic%5Fdisorders/common%5Fdisorders%5Fspine%5Fsholder%5Fpelvis/bursitis/Pages/index.aspx. Accessed December 15, 2013.
Elbow (olecranon) bursitis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00028. Updated January 2011. Accessed December 15, 2013.
Hip bursitis. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00409. Updated August 2007. Accessed December 15, 2013.
Prepatellar bursitis. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated September 5, 2012. Accessed December 15, 2013.
Questions and answers about bursitis and tendonitis. National Institute of Arthritis and Musculoskeletal and Skin Diseases website. Available at: http://www.niams.nih.gov/Health%5FInfo/Bursitis/. Updated June 2013. Accessed December 15, 2013.
Tendonitis/bursitis. American College of Rheumatology. Available at: http://www.rheumatology.org/Practice/Clinical/Patients/Diseases%5FAnd%5FConditions/Tendinitis%5Fand%5FBursitis/. Updated February 2013. Accessed December 15, 2013.

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