Bursitis
Introduction
Bursitis is a common condition that causes swelling around muscles and bones. It
happens most often in the shoulder, elbow, hip, or
knee.
Bursitis is usually caused by overusing a joint or by
direct injury to a joint. People who perform activities
that require repetitive motions or place stress on joints
are at higher risk for bursitis.
This reference summary will help you understand
bursitis. It explains its symptoms, causes and
treatment options.
Anatomy
Bursae are found throughout your body. Bursitis
occurs when one of your bursae becomes inflamed.
The following slides review information about your
bones and muscles to help you better understand how
bursitis affects your body.
Bones help you stand up straight and muscles help
your bones move together. Bones connect at the
joints. The most obvious joints are the shoulders,
elbows, wrists, hips, knees and ankles.
Other joints are found between the different bones of
your fingers and toes. You also have joints that allow your vertebrae to move.
The bones of a joint are covered on the ends by a material called cartilage. Cartilage
keeps your bones from rubbing against each other during motion.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
1
Between the 2 pieces of cartilage in a joint, there is a little bag lined by special tissue
known as synovium. The synovium secretes fluid that helps lubricate the joint. The
combination of cartilage and synovium allows for smooth, painless motion in any given
joint.
A bursa is a small, fluid-filled sac that acts like a
cushion between a bone and other moving body
parts such as muscles, tendons, or skin. They
are lined with synovial membranes.
Bursa
Bursae are found throughout your body. Bursitis
is what happens when one or more of your
bursae becomes swollen.
Symptoms
Bursitis means inflammation of one of your
bursa sacs. This inflammation happens in the
soft tissue around muscles and bones. It happens most often in the shoulder, elbow,
wrist, hip, knee, or ankle.
A stiff, achy feeling around your joint may be a sign that you have bursitis. If the pain
gets worse when you move or press on the joint, you may be experiencing symptoms
of bursitis.
The area around a joint with bursitis may also look
red and swollen.
See your healthcare provider if you also experience:
• Joint pain so severe that you have trouble
moving
• Pain that lasts more than one week
• A rash, redness, swelling, or bruising around a
joint
• A fever
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
2
Causes
A main cause of bursitis is overusing a joint. You may overuse a joint by doing
repetitive tasks.
Direct trauma to a joint can also cause bursitis. An example of direct trauma is
slamming your knee against the ground during a fall.
Bursitis usually develops in the knee or elbow. Kneeling or leaning your elbows on a
hard surface for a long time can lead to bursitis.
Inflammation of the bursa may also be caused by:
• Infection
• Arthritis
• Gout
• Thyroid disease
• Diabetes
Arthritis is a disease that causes inflammation and
pain in the joints. Gout is a form of arthritis caused
by high levels of uric acid. It causes swollen and stiff
joints.
The thyroid is a gland located beneath the voice
box. It helps control growth and metabolism.
Diabetes is a disease in which the body does not
control the amount of glucose in the blood. It also
causes the kidneys to make a large amount of urine.
Bursitis is also caused by old age. People perform a
lot of physical activities throughout their lives. These
activities require them to repeatedly use their joints.
Over time, this can cause the joints to become
inflamed.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
3
Risk Factors
Your risk of developing bursitis increases with age. As you get older, your joints
become more stressed. This increases the likelihood that you will develop joint-related
pain. For this reason, age is a risk-factor for
bursitis.
People who regularly perform tasks that require
repetitive motions have an increased risk of
developing bursitis. This includes carpenters,
gardeners, musicians, and athletes.
Certain medical conditions may also increase
your risk of developing bursitis. Arthritis, diabetes,
and gout have been linked to cases of bursitis.
Diagnosis
Diagnosis of bursitis begins with a medical history
and physical examination.
A good diagnosis depends on your healthcare provider knowing:
• The location of the pain
• When it began
• What you were doing when it began
• How long the pain lasts
• What relieves the pain
• What makes the pain worse
Your healthcare provider may perform a
selective tissue tension test to determine
which tendon is affected. Touching
specific areas of the tendon allows your
healthcare provider to pinpoint the area of
inflammation.
Your doctor may also use magnetic resonance imaging, or MRI, to confirm
inflammation. MRIs detect both bone and soft tissues like muscles, tendons and their
coverings, including bursae.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
4
An MRI is medical imaging in which radio waves and a powerful magnet linked to a
computer are used to create detailed pictures of areas inside the body. These pictures
can show the difference between normal and diseased tissue.
To rule out infection, your doctor may remove and test fluid from the inflamed area.
Treatment
Your healthcare provider can treat the common causes of bursitis. Complicated cases
may require referral to a specialist, such as an orthopaedist or rheumatologist.
Treatment focuses on healing the injured bursa. The first step in treating bursitis is to
reduce pain and inflammation.
Reducing pain and inflammation is done with rest, compression, and elevation.
Anti-inflammatory medicines such as aspirin, naproxen, or ibuprofen can also help.
Compression means pressing or squeezing together. In this instance, compression
refers to a bandage designed to
provide pressure to a specific area.
Ice may also be used in acute
injuries. However, most cases of
bursitis are considered chronic, and
ice is not helpful. Acute means the
injury was caused suddenly and has
been going on for a relatively short
period of time. Chronic means the
injury developed slowly over time and
the pain continues to return.
If bursitis is the result of an acute injury and ice is needed, an ice pack can be applied
to the affected area for 15–20 minutes every 4 to 6 hours for 3 to 5 days. Your
healthcare provider may recommend longer use of ice and a stretching program.
Your doctor may advise you to limit the amount of activity involving the affected joint to
encourage healing and prevent further injury.
In some cases, protective devices may temporarily reduce stress to the inflamed
bursa. This speeds up healing. Protective devices include foot orthoses for the ankle
and foot, or splints for the knee or hand. These devices allow general activities, like
walking, to continue as normal.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
5
For severe cases of bursitis, you may receive a corticosteroid injection into the area
surrounding the inflamed bursa. Even though corticosteroid injections are a common
treatment, they must be used with caution. They may lead to weakening or rupture of a
tendon. Corticosteroids that are used in the injections are man-made medicines. They
resemble hormones that the body naturally produces to fight inflammation.
Iontophoresis may also be used to deliver
corticosteroid medication to the affected area.
Iontophoresis uses an electrical current to push the
medicine through the skin, directly over the
inflamed bursa.
Severe cases of bursitis may also be treated with
therapeutic ultrasound. Therapeutic ultrasound is a
type of physical therapy in which sound waves are
used to massage certain tissues. It warms deep
tissues and can improve blood flow.
Iontophoresis
If there is still no improvement after 6-12 months, your healthcare provider may
perform surgery to repair damage and relieve pressure on the bursae.
If the bursitis is caused by an infection, your healthcare provider may prescribe
antibiotics. However, this is only an option if the infection is caused by bacteria.
Antibiotics cannot treat an infection caused by a virus. Always speak to a healthcare
provider before starting a medication.
Prevention
There are several ways to prevent inflammation or reduce the pain caused by
inflammation.
When engaging in physically demanding
activities:
• Warm up or stretch before an
activity
• Begin new activities or exercise
regimens slowly
• Increase physical demands after
completing several well-tolerated
sessions
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
6
• Talk to a physical trainer about exercises to strengthen the muscles around your
affected joints
When going about daily activities:
• Practice good posture and position your body properly
• Take breaks from repetitive tasks often
• Do not sit still for long periods
To reduce the pain caused by bursitis:
• Cushion the affected joint using knee and elbow pads that
have foam
• Increase the gripping surface of tools using gloves or
padding
• Use two hands to hold heavy tools or equipment
If you have a history of bursitis, talk to your healthcare provider
before engaging in new exercises and activities.
Summary
People get bursitis by overusing a joint. It can also be caused by direct trauma or
injury.
Your risk of developing bursitis increases with age. Regularly performing the same
motions also increases the risk of
developing bursitis.
Warming up or stretching before
beginning the activity, practicing good
posture, and using two hands to hold
heavy equipment are just a few ways to
prevent bursitis.
If you have a history of bursitis, talk to
your healthcare provider before
engaging in new exercises and
physically-demanding activities.
This document is for informational purposes and is not intended to be a substitute for the advice of a doctor or healthcare professional or a
recommendation for any particular treatment plan. Like any printed material, it may become out of date over time. It is important that you rely on the
advice of a doctor or a healthcare professional for your specific condition.
©1995-2016, The Patient Education Institute, Inc. www.X-Plain.com
Last reviewed: 03/21/2016
opf50102
7