Bursitis is inflammation (swelling, redness) of a fluid-filled sac called a bursa. Bursae are found in many parts of the body, usually where muscles and tendons move over bones. Tendons are tough bands of tissue that connect muscles to bones. Bursae help this motion by providing a gliding surface. Bursae are found in and around shoulders, elbows, hips, knees, and feet.
Bursitis can become frustrating. It tends to return, even after treatment, unless the activity causing it is stopped or changed.
Injuries from too much use and continued irritation are usual causes. Direct trauma, disorders such as rheumatoid arthritis and gout, and puncture wounds followed by infection may also cause bursitis.
Pain with swelling, redness, and tenderness are usual symptoms. Pain usually worsens with pressure against the affected muscle.
The health care provider will diagnose bursitis on the basis of the medical history and physical examination. The health care provider may also want x-rays to help rule out other causes of pain, such as a stress fracture or infection.
RICE (Rest, Ice, Compression, Elevation) is effective. Resting means stopping the activities for at least 2 weeks. Immobilizing the area with a splint or cast for 7 to 10 days sometimes works. Ice is placed on the area to reduce swelling and relieve pain. Antiinflammatory medications such as aspirin, ibuprofen, and naproxen can manage mild to moderate bursitis. Prescription antiinflammatory drugs are for severe bursitis that didn’t respond to other treatments and for extreme pain.
Aspiration, or removing fluid from the bursa, can provide temporary relief and gives the health care provider a chance to study the fluid for infection or gout. The fluid may return, however, which may lead to repeated aspiration and possible infection. Anti-inflammatory steroid injections can sometimes give relief. Infected tissue may need antibiotics or an operation to remove the tissue.
A physical therapist, occupational therapist, or athletic trainer may help retraining for activities to minimize the bursitis. Substituting other exercises for those that cause symptoms is important.
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