1. What Is a Bursa and What Is Bursitis?
A bursa is a fluid-filled sac that during movement decreases friction between ligaments, tendons and bones. Bursae can be found in many locations throughout the body including elbows, knees, hips and shoulders.
When a bursa becomes inflamed it is called bursitis. Bursitis can be caused by a variety of conditions including excessive repetitive movements, pressure, trauma and inflammatory diseases such as arthritis or gout in a neighboring joint.
2. What Are the Symptoms of Bursitis?
Symptoms can include pain with movement or palpation of the bursa. Sometimes there may be swelling if the bursa is close to the skin, which commonly occurs with bursitis near the elbow. Generally the tender bursa is not red and warm, and when this occurs there is a high likelihood of infection. This is a medical emergency and you should be seen immediately as it needs to be treated with antibiotics.
3. How Is Bursitis Diagnosed?
Typically, bursitis is diagnosed by symptoms and a physical examination. However, occasionally a sample of the bursal fluid will be needed to rule out an infection. An ultrasound can also be utilized to aid in diagnosis if the history is unclear or the physical examination is difficult.
4. How is bursitis treated?
Bursitis treatment consists of treating an infection if present, reducing inflammation and stopping activities that incited the bursitis to begin with. The bursa should be cushioned to avoid further injury, and ice can be applied to relieve pain and swelling. Ice should be applied with a towel or cloth between the ice and skin to prevent skin injury. Ice can be used for 15 to 20 minutes at a time every few hours, as needed. Medications such as ibuprofen, naproxen and indomethacin can help with the pain and inflammation. Sometimes a steroid injection may be the treatment of choice for unrelenting bursitis, as long as there is no infection involved. Rarely, surgery may be indicated when bursa are resistant to treatment.
If you suspect an infection please see your health care provider immediately to avoid further complications such as a joint infection.
5. How Can Bursitis Be Prevented?
Prevention of bursitis involves modification of activities or use of devices to avoid provoking the bursa. Cushions and pads can be used to decrease the pressure on the joints such as the knees during prolonged kneeling. Frequent rest periods are important and stopping the activity altogether may be required if the pain starts or persists. Weight loss should also be considered as excessive weight can cause unnecessary pressure on the joints and subsequently the bursa.
