Bursitis

Bursitis is a relatively common condition that affects millions of people in the United States. And while there are common risk factors that are seen in those diagnosed with the condition, anyone can get bursitis at any point in his or her life. However, there are ways to treat and prevent this painful condition.

Definition

Bursitis is the inflammation of the bursa, a small sack that is filled with a jelly-like fluid. There are 150 bursae throughout the human body. These sacks provide cushion between bones and the overlying soft tissue. This helps to reduce friction during movement. The two most common types of bursitis are olcranon bursitis (elbow) and prepatellar bursitis (knee).

Bursitis can either be acute, meaning that it occurs once as in the case of injuries, or it can be chronic in which it remains a problem, as is the case with repetitive use injuries.

Bursitis is considered to be a type of infectious arthritis condition, as the inflammation is often caused by an infection. The most common pathogen that causes the infection is the S. aureus, accounting for about 80 percent of all infection related cases, followed by the streptococci pathogen. It is important to know, that it doesn't always take an infection for a person to develop bursitis as there are other causes and risk factors associated with it.

Bursitis is diagnosed by physical examination and by a variety of laboratory and radiological tests, though it may not be necessary for a person to have all of them before the condition is treated. After a physical exam, a doctor may take a sample of the fluid in the bursa to test it for infection as well as blood tests that can look for a larger systemic infection in the body.

Causes And Risk Factors

Bursitis is most often caused by infection of the bursa, which results in pain and swelling. However there are other causes and risk factors, which include:

  • Direct trauma, such as a fall
  • Injections in or near the bursa, such as cortisone injections often used to treat other musculo-skeletal conditions
  • Infections that have spread from other areas. This is most common in the case of cellulitis
  • Other arthritic conditions, such as gout, rheumatoid arthritis, or CPPD (pseudo-gout)
  • Other orthopedic conditions such as tendonitis

There are certain things that place a person at higher risk for developing bursitis, including:

  • Diabetes
  • Thyroid disease
  • Overweight
  • Sedentary lifestyle
  • Female
  • Middle age or elderly
  • Repetitive use of a joint during activity such as stair climbing, running, or standing for a long period of time
  • Spinal diseases such as scoliosis or arthritis in the spine
  • Bone spurs or calcium deposits
  • Leg length inequality

Symptoms

The symptoms of bursitis include:

  • Joint pain or tenderness. Initially the pain may feel sharp and localized but over time it can become more widespread around the area
  • Stiffness or achy feeling when moving, although range of motion is usually not affected
  • Swelling
  • Redness
  • Warmth over the affected area

These symptoms are vague and are common in many orthopedic and rheumatic conditions. For this reason, it can be easily misdiagnosed. If a doctor suspects that a person has bursitis, but is unsure, tests such as x-rays and magnetic resonance imaging (MRI) can help confirm if bursitis is the problem.

Treatment

The treatment for bursitis will depend upon its cause. If the cause is an infection, simple antibiotics will help clear it up relatively quickly, within 1-4 weeks. However, if the cause is an acute injury or repetitive use, it may be a bit more difficult to treat.

If an injury is the cause, treating the injury can relieve the bursitis. This can mean anything from icing and elevation of an injured knee, to walking with crutches or using a wheelchair in the case of an injured hip. Often over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) can be used to help reduce swelling and pain and are generally considered safe.

One treatment that is used whether the cause is infection or injury is aspiration. This means that a needle is inserted into the bursa and fluid is removed to help reduce the swelling and pain of the bursa. This is often used when the exact cause can't be identified or when the person doesn't respond to other treatments. Surgery is also an option, but is not as common.

Often the best treatment is prevention. Those who have jobs or hobbies that require the repetitive use of major joints such as the shoulders, elbows, knees, hips or ankles should be careful to use proper body mechanics to prevent injury and treat any injury that they do sustain promptly instead of waiting for it to go away on its own.

Bursitis doesn't have to keep someone from doing what they love. With prompt treatment and precautionary measures, bursitis will heal and people can get back to doing what they love and living a pain-free life in no time.

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