Bursitis

What is going on in the body?

Bursae are fluid-filled sacs that act like cushions. They keep tendons and bones from rubbing against each other. Bursae are found in places like the shoulder, hips, knees and ankles. Bursitis occurs when bursae sacs become inflamed. Usually this happens if the bursae or tendon is over-used.

What are the causes and risks of the disease?

Bursitis is caused when the bursa sac of a particular set of bones and tendons becomes inflamed, usually due to overuse. Sometimes trauma to a bursa will cause bursitis. Bursae can become infected, although this is not common.

What are the signs and symptoms of the disease?

Bursitis causes pain and tenderness around the affected bone and tendon. This makes it hard to move this part of the body. Sometimes the bursae sacs fill with fluid when inflamed, which causes swelling over the bony part of the body. Fever may indicate another problem, such as joint infection or infection of the skin.

How is the disease diagnosed?

Diagnosis of bursitis is made by physical examination and history. The injured bursa will be tender when moved or pressed on. Occasionally redness or warmth can be felt over the affected area.

X rays and blood work are generally not done unless an infection is suspected. If so, a needle can be placed into the bursa to obtain fluid. This is sent for analysis to rule out infection and to confirm the diagnosis.

What can be done to prevent the disease?

Cushioning the part of the body affected or using stretching and warming exercises prior to exercise can sometimes prevent bursitis. Using a soft mattress cover or foam mattress can help prevent bursitis of the outer hip region.

What are the long-term effects of the disease?

Bursitis can become chronic causing scarring of the bursae and a limited range of motion.

What are the risks to others?

Bursitis is not contagious and does not put others at risk.

What are the treatments for the disease?

Treatments include rest, icing the affected bursa, and using non-steroidal anti-inflammatory drugs, such as ibuprofen or naproxen, or other pain relievers. If this does not work, an injection of steroids, such as cortrisone, into the affected bursa can provide dramatic relief. To do this, the area of skin over the bursa is sterilized with a cleaning solution and a small needle is placed into the bursa, releasing steroids and numbing medicine. After a few days the steroids will calm the inflammation, relieving the pain and improving range of motion.

What are the side effects of the treatments?

Some people cannot take anti-inflammatory drugs since they can irritate the stomach and, if taken on a regular basis, can produce stomach ulcers.

Injections are usually well tolerated, but should not be given to anyone allergic to steroids or nerve numbing medicine like lidocaine. Injections can cause infection or bleeding, although this is rare. People on blood thinners, such as warfarin or aspirin, should talk to their doctors before having a steroid injection.

What happens after treatment for the disease?

After an injection, people should rest and apply ice to the affected bursa. Anti-inflammatory drugs may be taken along with the steroid injection to help relieve pain and swelling. As the bursitis resolves, people may return to their former activities. But, this can cause the bursitis to recur if it is done too soon.

How is the disease monitored?

The disease is monitored by physical examination.