Bursitis
What is it?
Bursitis is inflammation of a bursa—one of the small, fluid-filled sacs located near joints and bony prominences throughout the body. The bursae act as cushions between muscles and tendons and between muscles and bones. They produce a lubricating fluid to minimize friction at these sites, thus facilitating joint movement. Irritation, overuse, infection, or injury can inflame a bursa, resulting in painful bursitis. The shoulders, elbows, hips, knees, heels, and the base of the big toe are among the sites most often affected. Bursitis is so common that it has acquired a number of familiar names, including student's elbow and housemaid's knee. Bursitis is not serious and usually subsides on its own within one or two weeks if the aggravating activity is altered or stopped; how- ever it has a tendency to recur.
What Causes It?
- Activities that put constant pressure on a bursa (such as resting the elbow on a desk or kneeling).
- Repetitive and vigorous joint movement.
- A blow or other injury to a bursa.
- Inflammatory arthritis, gout, and certain infections.
- Calcium deposits in, or degeneration of, a nearby tendon is sometimes associated with bursitis.
Prevention
- Wear protective gear when playing sports. Check with a coach, trainer, or professional to be sure that you are using proper techniques.
- Avoid overly strenuous or repetitive physical activities if possible.
- If you must work in a kneeling position, use knee pads or cushions, change positions often, and take frequent breaks.
- To prevent bursitis in the feet, wear high heels only when you must; buy new running shoes when old ones wear out; wear shoes with a properly fitting heel.
Diagnosis
- Patient history and physical examination are needed.
- X-rays of the affected area may be necessary to rule out other disorders.
How to Treat It
- Rest and avoid putting pressure on the affected area. Your doctor may prescribe splints, braces, or slings to keep the joint still.
- Take over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), which relieve pain and swelling, or acetaminophen, which will relieve pain but won't reduce inflammation.
- Use ice packs for the first 48 hours to relieve pain and swelling. Then, if desired, switch to heat packs, which stimulate blood flow and ease pain.
- To reduce swelling, your doctor may draw excess fluid from the bursa with a syringe and then tightly bandage the joint.
- Your doctor may administer injections of corticosteroids and a local anesthetic to reduce swelling and ease pain.
- Gradually resume using the affected joint to prevent stiffening and muscle atrophy, although naturally you should temporarily avoid any activities that aggravate the condition.
- Surgery to remove the bursa may be necessary in severe, persistent cases.
When to Call a Doctor
- Make an appointment with a doctor if joint pain or swelling persists for more than two weeks despite treatment.
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Copyright © 2008 Medletter Associates, LLC
Content excerpted from Johns Hopkins Symptoms and Remedies: The Complete Home Medical Reference.