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Bursitis

Definition

Bursitisis the swelling and irritation of a bursa. A bursa is a fluid-filled sac that acts as a cushion between a muscles, tendons, and joints.

Causes, incidence, and risk factors

Bursitis is often a result of overuse. It can be caused by a change in activity level, such as training for a marathon or by being overweight.

Bursitis can also be caused by trauma, rheumatoid arthritis, gout, or infection. Sometimes the cause cannot be found.

Bursitis commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the Achilles tendon and the foot.

Symptoms

  • Joint pain and tenderness when you press around the joint
  • Stiffness and aching when you move the affected joint
  • Swelling, warmth or redness over the joint

Treatment

Your doctor will talk to you about strategies to help you resume your normal activity.

Tips to relieve bursitis pain:

  • Use ice 3 - 4 times a day for the first 2 or 3 days. 
  • Cover the painful area with a towel, and place the ice on it for 15 minutes. Do not fall asleep while applying the ice.  with the ice on. You can get frostbite if you leave it on too long.
  • When sleeping, do not lie on the side that has bursitis.

For bursitis around the hips, knees, or ankle:

  • Try not to stand for long periods of time.
  • When standing, stand on a soft, cushioned surface. Stand with an equal amount of weight on each leg.
  • Placing a pillow between your knees when lying on your side can help decrease your pain.
  • Flat shoes that are cushioned and comfortable often help.
  • If you are overweight, losing weight may also be helpful.

You should avoid activities that involve repetitive movements of any body part whenever possible.

Other treatments include:

  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen
  • Physical therapy
  • Exercises you do at home to build strength and keep the joint mobile as pain goes away
  • Removing fluid from the bursa and getting a shot of corticosteroids

As the pain goes away, your doctor or nurse may suggest exercises to build strength and keep movement in the painful area.

Surgery is rarely needed.

Expectations (prognosis)

Some people do well with treatment. When the cause cannot be corrected, you may have long-term pain.

Complications

  

Calling your health care provider

Call your health care provider if symptoms recur or do not improve after 2 weeks of treatment.

Prevention

Avoid activities that include repetitive movements of any body parts whenever possible.

References

Silverstein JA, Moeller JL, Hutchinson MR. Common issues in orthopedics. In: Rakel RE, ed. Textbook of Family Medicine. 8th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 30.

Review Date: 8/14/2012
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
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