Bursitis

Bursae (singular: bursa) are fluid-filled sacs located throughout the body, and found around the shoulder, elbow, hip, knee and heel. They cushion the area between bones and the overlying soft tissue and reduce the friction between the muscles and bones. When these bursae become inflamed, this is known as bursitis.

Causes, incidence, and risk factors

Although the cause cannot always be determined, bursitis can be caused by chronic overuse, trauma, rheumatoid arthritis, gout, or infection. It commonly occurs in the shoulder, knee, elbow, and hip. Other areas that may be affected include the Achilles tendon and the foot.

Symptoms

• Joint pain and tenderness when you press around the joint
• Stiffness and achiness when you move the affected joint
• Swelling, warmth or redness over the joint

Diagnosis

Your orthopaedic surgeon will

• Take a complete medical history
• Perform a physical exam to determine the area of pain and identify any tenderness in the affected areas
• Request x-rays, bone scanning and Magnetic Resonance Imaging (MRI) as deemed necessary

Treatment

Many people with bursitis can experience relief with simple lifestyle changes such as:

• Weight loss to ease the stress upon the inflamed bursae
• Avoiding activities that worsens symptoms
• Use of heat or ice for pain relief.
• Use of Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may relieve pain and inflammation.
• Formal physical therapy may be helpful as well.
• The stretching movements associated with yoga, tai-chi and pilates may help to improve flexibility in the joints, strengthen muscles, and improve the range of motion (ROM) depending on the affected areas.

When conservative treatments prove ineffective in providing relief, it may become necessary to drain the affected bursa and receive an injection of corticosteroids along with a local anaesthetic to relieve symptoms of bursitis. Surgery is rarely required. However, surgical removal of the bursa may be recommended in painfully chronic cases of bursitis. When bursitis is caused by infection, then a course of antibiotics is would be used to treat the condition.