Overview

shoulder structures
Shoulder structures.

Bursitis is the inflammation of the bursa, a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons, or skin.

With bursitis, the bursa becomes red and fluid increases, causing swelling and pain.

 

Symptoms

Bursitis can cause pain in your joint, especially when you move it, and swelling.

Causes

Bursitis is usually caused by overusing a joint or trauma to a joint. For example, if you kneel or lean on your elbows longer than usual on a hard surface, you may be at risk for bursitis. An infection, arthritis, gout, thyroid disease, or diabetes can also cause bursitis.

If you do activities that require repetitive motions or place stress on your joints – such as carpentry, gardening, playing a musical instrument, or playing a sport – you may be at a higher risk for bursitis.

Diagnosis

To diagnose bursitis, your doctor will probably ask questions about your medical history and examine you. You will probably be asked to describe your joint pain and the circumstances in which it occurs. The location and onset of pain, whether your pain varies in severity throughout the day, and factors that relieve or aggravate your pain may all help your doctor determine whether bursitis is causing your pain.

Your doctor may also do manual examinations of the joint to see whether tendons, another part of your joints, are inflamed. They may also recommend x-rays, which do not show the bursae, but which may help rule out other problems. A magnetic resonance imaging (MRI) test can show whether the tendons or bursae are inflamed. Your doctor may also remove and test fluid from the inflamed area to rule out infection.

Treatment

Treating bursitis can reduce pain and inflammation and allow the injured bursa to heal. Some common treatments for bursitis include:

  • Resting and elevating the injured area.
  • Limiting your activity to reduce further injury.
  • Taking anti-inflammatory medicines, such as aspirin, naproxen, or ibuprofen.
  • Gentle stretching and strengthening exercises recommended by a doctor.
  • Applying compression to the injured area.
  • Putting a brace, splint, or band on the injured joint. 

If an infection is causing your bursitis, your doctor will probably prescribe antibiotics. Your doctor may also recommend ice for acute injuries, but most cases of bursitis are chronic, and ice is not helpful.

If your bursitis does not improve, your doctor may inject a corticosteroid medicine into the area surrounding the inflamed bursa. Although these injections are common, they must be used with caution because they can lead to weakening or rupture of tendons. If your bursitis does not improve after 6 months to a year, your doctor may recommend surgery to repair damage and relieve pressure on your bursae.

Who Treats

Diagnosing and treating bursitis is a team effort involving you and several types of health care professionals. Depending on the severity of the condition, these may include:

  • A primary care physician.
  • Physical therapists, who help to improve joint function.
  • Orthopaedists, who specialize in the treatment of, and surgery for, bone and joint diseases or injuries.
  • Rheumatologists, who specialize in arthritis and other diseases of the bones, joints, and muscles.

Prevention

To help prevent inflammation or reduce the severity of its recurrence:

  • Begin new activities or exercise regimens slowly.
  • Gradually increase physical demands following several well-tolerated exercise sessions.
  • Exercise regularly.
  • Strengthen muscles around the joint.
  • Take breaks from repetitive tasks often.
  • Stop activities that cause pain.
  • Cushion the affected joint. Use foam for kneeling or elbow pads. Increase the gripping surface of tools with gloves or padding. Apply grip tape or an oversized grip to golf clubs.
  • Use two hands to hold heavy tools; use a two-handed backhand in tennis.
  • Don’t sit still for long periods.
  • Practice good posture and position the body properly when going about daily activities.