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Joint Pain? It Might Be Bursitis
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What is bursitis? Explore facts, treatments, and symptoms of
bursitis. Learn about bursitis of the hip, knee, and shoulder.
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What Is Bursitis?
Bursitis is inflammation
of the bursae, the fluid-filled sacs that protect against friction between
bones and other tissues. Depending on the location in the body, bursae may
cushion bones from other bones, tendons, muscle, or skin. Bursitis can occur in
many areas of the body. It is most common in the elbows and wrists. The ankles,
hips, or knees may also be affected. Bursitis is caused by overuse injury or
other trauma. Repetitive movements increase the risk of bursitis. Certain
conditions like thyroid disease, diabetes, arthritis, and infections can
inflame the bursa.
Hip Bursitis
Hip
bursitis occurs as a result of inflammation of one of two bursae located around
the hip. Trochanteric bursitis is inflammation of the bursa that covers the end
of the long bone of the leg (femur). It is more common than iliopsoas bursitis,
which is inflammation of the bursa on the inside of the hip in the groin. In
addition to the usual risk factors for bursitis, a difference in the length of
the legs and spine disorders (arthritis, scoliosis, and others) also increase
the risk of bursitis.
Knee Bursitis
Knee
bursitis occurs when the bursa in front of the kneecap becomes inflamed. Strain
on the knees from kneeling is a common cause of knee bursitis. Direct trauma to
the knee or conditions such as rheumatoid arthritis or gout also increases the
risk. Sometimes a bug bite or wound introduces bacteria into the bursa, causing
inflammation associated with infection. Knee bursitis may produce symptoms like
swelling, warmth, and pain with use.
Elbow Bursitis
Elbow
bursitis is inflammation of the bursa covering the pointy part of the elbow
called the olecranon. Leaning on the elbows for extended periods of time may
cause elbow bursitis. Injury, infection, and arthritic conditions may
contribute to the condition. Elbow bursitis may cause swelling and pain. If
swelling is very severe, it may impair use of the elbow joint.
Shoulder Bursitis
The
shoulder is a complicated joint that allows for a wide range of motion. The
upper arm bone (humerus) is held within the socket by muscles and tendons on
the top of the shoulder known as the rotator cuff. The rotator cuff attaches
the arm to the shoulder blade (scapula). A bursa cushions the space between the
rotator cuff and a portion of the scapula called the acromion. Inflammation of
the bursa may cause pain, swelling, and stiffness. Overuse injuries due to
sports like swimming and tennis may cause shoulder bursitis. Pain may occur
when using the arm as well as at rest.
Heel Bursitis
Heel
pain can be caused by a variety of reasons. Pain in the back of the heel may be
due to inflammation of the bursa located in the area where the heel bone
connects to the Achilles tendon. This bursa is called the retrocalcaneal bursa.
Overuse injury from running may cause retrocalcaneal bursitis. Ill-fitting
shoes that cut into the back of the heel can also provoke the condition. This
type of bursitis may be very painful and make it hard to walk and do normal
activities.
Ischial Bursitis
Ischial
bursitis is inflammation of the bursa that lies between the buttocks and the
sitting bones. Sitting too long may cause ischial bursitis. Falling on the area
may also provoke the condition. Once the ischial bursa is inflamed, sitting,
walking, running, and climbing stairs may aggravate the condition and cause
pain.
Aseptic vs. Septic Bursitis
Septic
bursitis refers to inflammation of the bursa caused by an infection. Aseptic
bursitis refers to inflammation of the bursa that is caused by something other
than infection, such as rheumatoid arthritis, gout, physical trauma, or overuse
injury. The majority of cases of septic knee bursitis (80%) are caused by the
bacteria Staphylococcus aureus. Other organisms, including fungi,
Streptococcus, Brucella, and Mycobacteria may cause septic bursitis. The
condition is managed by resting, draining excess fluid, and administering
antibiotics.
Calcific Bursitis
Calcific
bursitis refers to calcium deposits that build up in a bursa and cause pain and
inflammation. The shoulders are the most common site for calcific bursitis
although the hips, knees, wrists, and elbows may also be affected. Calcific
bursitis may be associated with buildup of calcium deposits in nearby tendons
as well.
Bursitis Diagnosis
Bursitis can be
diagnosed by a doctor based on a medical history, exam, and tests. Tests may
include imaging with X-rays, an ultrasound, or an MRI. The doctor may order
blood work or microscopic investigation of fluid drained from the affected
bursa. Once the underlying cause of bursitis has been identified, the doctor
can determine the appropriate course of treatment.
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Bursitis Treatment
Treatment
for bursitis depends on the underlying cause. Rest, Ice, Compression, and
Elevation (RICE) is one strategy to decrease the symptoms of bursitis. Pain and
swelling may be managed with nonsteroidal anti-inflammatory drugs (NSAIDs). If
the bursa is very swollen, the doctor may drain excess fluid. Corticosteroids
injected into the affected bursa are sometimes used to decrease inflammation.
The doctor may recommend the use of a cane, splint, brace, or other support to
reduce stress on the affected joint. In some cases, physical therapy may be
ordered to help strengthen the area and encourage improved mobility. Surgery
may be considered in severe cases when other treatments have been ineffective.
Bursitis Prevention
Taking
certain precautions with movement is a way to protect joints and decrease the
risk of bursitis. Changing positions and taking breaks every 20 to 40 minutes
helps minimize strain on any one joint. Warming up and stretching before
exercise helps protect joints. Exercising regularly and building up strength is
better than pushing oneself too hard and straining joints that have not yet had
the chance to adapt to increased amounts of activity. Stopping activities that
cause pain is also a good idea.
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Reviewed by Aimee V. Hachigian-Gould, MD on Tuesday,
June 21, 2016
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Bursitis:
Treatments for Hip, Knee Shoulder and More
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Sources: 
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This tool does not
provide medical advice.
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