What Is Bursitis?
izusek / Getty Images
Medically reviewed by Stella Bard, MD
Bursitis is a condition characterized by inflammation of the bursa, which are fluid-filled sacs located between bones and nearby soft tissue, bones and tendons, and muscles. Bursa can be found all over your body. Bursitis can occur in any bursa but is most common in the shoulders, hips, elbows, and knees. They are intended to reduce tension and friction in these areas, keeping them protected from wear and tear.
Bursitis can be caused by a variety of injuries and medical conditions. Your healthcare provider will work with you to determine the underlying cause of your bursitis, treat it if possible, and provide options to help manage your symptoms. A majority of bursitis cases clear up within a few weeks.
Types
Bursitis can be broken down into two types based on duration: acute (which means it lasts for a short period and then resolves) and chronic (meaning it is an ongoing problem for multiple months or more). It can also be broken down by areas affected, such as the knees or hips.
Duration
Acute bursitis is often caused by infection, physical trauma, or crystalline joint diseases like gout. With this form of bursitis, the affected bursa is typically painful to the touch, and the pain is aggravated by movement. However, is important to be evaluated by your healthcare provider because there are exceptions. For example, if the affected bursa is deep below the skin, it may not be painful to the touch and still be acute bursitis.
Chronic bursitis is frequently caused by repetitive pressure or overuse that leads to injury and inflammation over time. Inflammatory arthritis—which is a type of joint inflammation caused by either an infection or an autoimmune response causing your body to attack itself—can also lead to chronic bursitis.
Unlike acute bursitis, this type may not be painful to the touch. It can be recognized by significant swelling as the bursa expands to accommodate the extra fluid build-up. The skin over the affected bursa may also feel warmer to the touch than the surrounding area.
Areas Affected
In addition to duration, the types of bursitis can be broken down by the areas of the body it is affecting. It can occur in more than one area at a time. These types include:
Subacromial: This is the area between the humerus (a bone in the upper arm) and the coracoacromial arch above. Together, these make up a portion of your shoulder.
Olecranon: This is the bony area of the elbow above the ulna (a bone in the forearm).
Trochanteric: This is in the hip joints.
Prepatellar: This is in the area at the front of the knee called the patella.
Infrapatellar: This is the area directly below the kneecap, just below the patella.
Bursitis Symptoms
Your symptoms may vary depending on which type of bursitis you have. However, many people with bursitis will experience the following symptoms:
Pain in the area of the affected bursa. Often this pain is described as "dull" or "aching."
The area is tender when touched
The skin over the affected area is warmer than the surrounding area
The area is swollen or puffy
Pain will increase with movement. Depending on where the bursitis is, some types of movements may aggravate the pain more than others
What Causes Bursitis?
Bursitis occurs when a trigger irritates a bursa and causes it to become filled with a type of bodily fluid called synovial fluid. When the bursa becomes overly full, it begins pressing on the bones and other body parts around it. This pressure results in much of the pain associated with the condition.
Bursitis has many triggering causes and events, including:
Traumatic injury (caused by a more sudden physical trauma)
Repetitive or overuse injury (caused by repetitive motions over time)
Infection
Crystalline joint diseases like gout and calcium pyrophosphate deposition (CPPD)
Inflammatory arthritis
Autoimmune disorders
Anyone is capable of developing bursitis, but certain factors put you at an increased risk. For example, older individuals are at increased risk for bursitis as well as individuals with certain chronic diseases like diabetes, human immunodeficiency virus (HIV), some rheumatologic disorders, and long-term overconsumption of alcohol. Some people have natural body variations, such as having legs of different lengths, that increase their risk of some types of bursitis.
Bursitis occurs roughly equally among men and women, but women appear to be at increased risk for certain types of bursitis. Some forms of bursitis are more commonly found in people with obesity. Certain occupations—particularly jobs that require manual labor—cause workers to have an increased risk of bursitis.
Diagnosis
To diagnose bursitis, your healthcare provider will begin by examining the affected area and asking you questions about your health history and any recent injuries.
Symptoms of bursitis can be similar to other conditions such as stress fractures or ligament tears depending on where you are experiencing them. Therefore, your provider may order imaging such as an X-ray to rule out other potential conditions or determine if an injury may be causing your bursitis.
Some types of imaging such as magnetic resonance imaging (MRI) or ultrasound may be used to look at the bursa itself and help distinguish the triggering mechanism for the bursitis such as infection.
Treatments for Bursitis
The majority of bursitis cases will eventually go away on their own. Your healthcare provider may recommend doing some of the following at home to help manage your symptoms:
Rest the affected area
Apply an ice or cold pack to the area
Compress the area (which can be done with a compression sock or sleeve), depending on its location
Elevate the area above your heart for 15-20 minutes at a time, if possible, which helps reduce swelling by sending built-up fluid back toward your heart
Protect the area with padding, by using a donut cushion for sitting, or wearing supportive footwear
In addition to at-home treatment and management, your healthcare provider may also recommend some of the following:
Physical or occupational therapy: Physical and/or occupational therapists can assist you in performing exercises to stretch and strengthen the affected area
Pain medications: Begin with over-the-counter options like Tylenol (acetaminophen). In more severe cases, your provider may recommend a steroid injection.
Treat the underlying condition that caused the bursitis: For example, if the bursitis is due to an infection, your provider will likely prescribe antibiotics.
Surgery: In severe cases, your provider may talk with you about surgical options for treatment.
Some research has also shown that kinesio taping may be effective at reducing pain for certain types of injuries and rheumatoid conditions. Kinesio tape—also called k-tape or KT—is made of an elastic cotton strip with an adhesive that is attached to your skin to help provide support and improved range of motion. However, more research is needed to analyze the effect of kinesio tape on people with bursitis, specifically.
Prevention
Not every case of bursitis will be able to be avoided. However, there are some ways you can reduce your chances of developing bursitis.
It is important to ensure you are using proper technique and good body mechanics during manual labor and sports to reduce your chance of an overuse injury. Make sure you warm up properly before physical activity, utilize padding if you know you are going to be putting pressure on your joints for an extended period (such as knee pads if you will be kneeling), and take frequent breaks from strenuous activity.
Talk with your healthcare provider about how you can reduce your chances of developing conditions like diabetes, which can cause and worsen bursitis. If you are concerned that you may be developing bursitis, seek medical care as soon as you are able.
Related: How to Prevent Type 2 Diabetes
Complications
Bursitis may resolve on its own but, in some cases, you may be at risk for complications if you don't receive medical intervention. Some potential complications of bursitis include:
Sepsis: If your bursitis is due to an infection that goes untreated, it may turn into sepsis, a life-threatening reaction to extreme infection.
Atrophy: If you are not able to move a part of your body for an extended period due to pain, your muscles may lose mass and become weak.
Frozen shoulder: If you have bursitis in your shoulder area you may develop a condition called frozen shoulder, which causes pain and stiffness and can reduce mobility in the area.
A Quick Review
Bursitis begins when the bursa—fluid-filled sacs between your bones and joints—becomes inflamed. This can be caused by a variety of factors, including physical trauma, overuse, and infection. Symptoms and causes can vary depending on whether your bursitis is acute or chronic.
Treatment generally focuses on pain and symptom management, but surgical intervention may be considered in more severe cases. Physical therapy and occupational therapy may help with both reducing symptoms and preventing bursitis in the first place.
It is important to speak with your healthcare provider to get an accurate diagnosis and to develop a plan of care that works for you.
Frequently Asked Questions
Does walking help bursitis?
Therapies for bursitis will vary depending on where in the body your pain is. In some cases, certain movements will irritate your bursitis and your healthcare provider may recommend rest. Talk with your provider and physical therapist about what movement may be best to help your bursitis.
Can bursitis be seen on an X-ray?
Inflammation is not generally visible on X-ray. However, an X-ray may be able to help with a diagnosis by ruling out other causes of pain such as fractures, bone spurs, or foreign objects.
How long can bursitis last?
Bursitis typically goes away within a few weeks. Some people develop chronic bursitis, which may last months. If you do not avoid your triggers, you may experience recurrences.
For more Health.com news, make sure to sign up for our newsletter!
Read the original article on Health.com.
