Bursitis is an inflammation of the bursa in a joint. The bursa is a fluid-filled cavity between the tendon and the bone in a joint. It acts as a sort of bumping bag, which protects the joint from too much friction. In case of bursitis, moving the joint will be uncomfortable or painful.
A person may get bursitis for various reasons:
- Accident. By a fall or a blow to, for example, the shoulder, the bursa can become irritated and inflamed.
- Inflammation. If a joint is inflamed, the inflammation can spread to the bursa. This is common in gout. If the bursa itself is damaged, such as due to an accident, a bacterium in the bursa can cause inflammation.
- Overload. Repeating certain movements too often can cause bursitis. We also see this together with RSI. By frequently supporting on the elbow, the bursa can get inflamed (students elbow).
Certain types of bursitis are more common in some professions and some sports. Runners are at risk for bursitis in the Achilles tendon. This is often accompanied by tendinitis. Bursitis in the knee (father’s knee) is common in pavers and carpet men. Carpenters and masons are more likely to have bursitis in the elbow.
When the bursa becomes inflamed, it produces extra fluid. This makes the bursa expand. As a result, the joint hurts and gets stiff. The joint can be moved less well. The skin may be red and hot at the site of the inflamed bursa. A swelling may arise at that spot. Bursitis is common in the shoulder, elbow and knee.
The doctor can often conclude that a person has bursitis from the person’s history and physical examination. He or she will sometimes take some fluid from the swelling for further investigation. This happens, for example, when the doctor wants to know if a bacterial infection is the cause. Blood tests and additional examination, such as X-rays, exclude other causes.
Depending on the cause of bursitis, a particular treatment will be chosen. When posture or overload is the cause and the symptoms are not severe, the doctor may refer the patient to a physical therapist for posture and exercise advice. If the cause is not the bursa itself, but the joint, for example due to gout, the doctor will deal with this first. If there is a bacterial infection, the patient receives antibiotics. The doctor may prescribe an anti-inflammatory painkiller, also called NSAID. This will reduce the swelling and stiffness of the joint. In case of severe bursitis, the doctor can inject corticosteroids into the bursa or prescribe them as a tablet.
If the above treatments don't work, it may be that the patient needs surgery. In an operation, the bursa is then removed. This is a relatively minor procedure.
Usually, bursitis only lasts temporarily. With the right measures and treatment, the symptoms may disappear. However, the symptoms can sometimes become chronic.
- Bursitis often heals on its own by letting the inflamed joint rest.
- It’s important to prevent overloading the joint involved, also in future.