Bursitis

Bursitis is a common problem caused by swelling and pain of a bursa, one of the more than 150 small sacs that keep the muscles, bones, tendons and skin gliding smoothly and cushion them from each other while you're in motion. Bursitis can be acute (short-term) or chronic (long-term), and can range from mild to moderate to severe. The bursa sacs of the knee, hip, elbow and shoulder cause the great majority of problems, doctor visits and physical therapy sessions.

People often confuse bursitis with tendinitis, an inflammation of one of the body's many tendons (which attach muscles to bones). In some cases, you could have both at the same time. This is most common in shoulder injuries. A physician can tell whether you have one or both problems.

Bursitis most commonly occurs on one side. Usually, it is an injury resulting from overuse, repetitive motion or even repetitive postures that put pressure on the same joint, in the same position, for a long period. Workers who put on roofs, lay flooring, smooth cement with a trowel or clean floors on their hands and knees often suffer bursitis of the knee from the pressure on a knee over an extended period. People who sit for a long time (at a computer with their elbows resting on chair armrests, for instance) will sometimes suffer bursitis of the elbow. Bursitis can occur after repeated, long-term pressure on a joint, or it can occur immediately after an impact on a joint (from an automobile crash, fall or athletic injury, for example). Infection of the bursa sac can also cause bursitis, but that is much less common.

Bursitis affects men and women about equally and can be a vexing problem for a high school athlete or a grandmother. Bursitis of the hip, however, is more common in older adults and more difficult to treat because it is harder to rest the hip than other joints. You use your hips each time you stand from a seated position, walk or climb stairs. Bursitis of the hip can cause pain even when you lay on your side trying to sleep. Sometimes the cause of bursitis will be clear, while other times the cause will remain unclear.

What to Do

If there's severe pain, call your doctor right away. If you have undiagnosed chronic pain near a joint that has not significantly improved after two weeks of self-care, make an appointment to see a doctor. The doctor might prescribe medication, might drain fluid from the bursa and then might inject it with medication. A doctor may also recommend physical therapy and stretching exercises you can do at home. In most cases, with treatment, it takes two to six weeks to recover from bursitis.

Use Medicine Effectively

Several nonsteroidal anti-inflammatory medications (NSAIDs) are available to ease the pain of bursitis. Your physician will choose one based on your condition and based on whether your stomach or kidneys are sensitive to this class of drugs. You should usually take NSAIDs with food. The physician also may inject your swollen bursa sac with a corticosteroid, a medication that acts directly on inflammation.

Self-care Steps for Bursitis

• If pain is not severe, you can use an ice bag over the painful joint for 20 to 30 minutes, three or four times a day.

• Be careful about staying in a position that puts pressure on your painful joint for a prolonged period.

• Wear knee or elbow pads for cushioning if you have a job in which you must kneel on your knees or lean on your elbows for a prolonged period. This can help prevent bursitis in these areas.

• Limit your use of the painful joint.

• If your bursitis involves the hip, try not to sleep on the painful side.

• If your bursitis is in the shoulder, keep your shoulder below a 90-degree angle to reduce strain on the joint.

• Use a compression bandage on the elbow or knee to reduce swelling.