Bursitis is the painful inflammation of a bursa - a fluid filled sack that cushions joint movement. Bursitis most commonly affects the shoulder bursae but is also common in the other major bursae located near the hips, elbows, knees and heels.
Common symptoms include pain and swelling, arising from a range of causes such as strenuous physical activity and injury.
Bursae (singular = bursa) are small, fluid filled sacs found in areas of the body that are subject to movement and friction. Bursae contain a small amount of synovial fluid - a transparent lubricating fluid - and act to cushion the movement between the bones, tendons and muscles near the joints.
Bursitis can occur in any of the more than 150 bursae throughout the body. “Students elbow” and “Housemaid’s knee” are colloquial terms used to describe two common forms of bursitis.
Signs and symptoms
Common symptoms include:
- Restricted movement.
The pain caused by bursitis may be worse in the mornings and after periods of exercise or strenuous activity.
Bursitis can occur for a variety of reasons, including:
- Strenuous or repeated physical activity
- Underlying rheumatic/arthritic conditions such as pseudogout or gouty arthritis.
Bursitis caused by infection (septic bursitis) is uncommon. Infection may be introduced as a result of a break or puncture in the overlying skin. Rarely, bacteria circulating in the blood can infect a chronically inflamed bursa. Occasionally bursitis can occur for no known reason.
Chronic (long-term) bursitis that is left untreated can result in a build up of calcium deposits (calcific bursitis) in the soft tissues, resulting in permanent loss of movement to the area.
A doctor may undertake the following in order to diagnose bursitis:
- Physical examination and full medical history
- Blood tests
- Taking a sample of the fluid in the affected bursae to rule out infection or underlying conditions.
The treatment of bursitis will depend on whether or not there is infection present. In cases where there is no infection (aseptic bursitis) treatment will focus on reducing inflammation, including:
- Ice compresses applied to the area to reduce swelling and discomfort
- Resting the affected area (it may be necessary to restrict or stop the activity that has caused the bursitis)
- Wearing a support on the injured joint eg: a sling for shoulder or elbow bursitis
- Anti-inflammatory pain relieving medications
- Cortisone (steroid) injections into the affected area
- Occasionally, the fluid may need to be aspirated (removed using a needle and
syringe) from the affected bursa in order to relieve pressure. This may need to be done more than once
- Weight loss may be recommended in some cases in order to help to relieve pressure on the affected joint(s).
Some people find alternative therapies such as acupuncture, chiropractic and naturopathy effective in relieving the pain associated with the condition.
When infection is present (septic bursitis) antibiotics may need to be given. In severe cases, this may involve hospitalisation in order for the antibiotics to be given intravenously (through a drip into a vein).
In severe, chronic cases, surgical removal of the damaged bursa (bursectomy) may be necessary.
Anderson, K.N., Anderson, L.E. & Glanze, W.D. (eds.) (2006) Mosby’s Medical, Nursing, & Allied Health Dictionary (6th ed.) St. Louis: Mosby-Year Book, Inc.
Ericson. K. (2006) Bursitis. Gale Encyclopaedia of Medicine, Third Edition. Karen L. Longe, Editor. Farmington Mills, MI. Thompson Gale.
MedicineNet (2011) Bursitis. Foothill Ranch MedicineNet.Inc
Last Reviewed – May 2013