Bursitis

Bursitis is commonly caused by:

• Overuse of bones, tendons and muscles near your joints and repeated movements, including daily activities like using tools, gardening, cooking, cleaning and typing at a keyboard
• Long periods of pressure on one particular area; for example, people who work on their knees all day such as carpet layers, roofers or gardeners can develop bursitis over the kneecap
• Aging, which can cause the bursa to break down over time
• Sudden injury, such as a blow to the elbow

Bursitis can also be caused by other problems, such as arthritis or infection (septic bursitis).

Bursitis usually causes a dull pain, tenderness and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch.

Bursitis is most common in the shoulder, elbow, hip and knee. Bursitis may also occur near the Achilles tendon or in the foot.

Symptoms of bursitis may be like those of tendinopathy. Both occur in the tissues in and around joints. Check with your doctor if:

• Your pain is severe
• You develop a fever
• The sore area becomes very hot or red

Your doctor will check for bursitis by asking questions about your past health and recent activities and by examining the area.

If your symptoms are severe or get worse after treatment, you may need other tests. Your doctor may drain fluid from the bursa using a needle (aspiration) and test it for infection. You may also need X-rays, an MRI or an ultrasound.

Home treatment is often enough to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen the muscles around your joints.

• Rest the affected area. Avoid any activity or direct pressure that may cause pain.
• Apply ice or cold packs as soon as you notice pain in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for three days (72 hours). You can try heat, or alternating heat and ice, after the first 72 hours.
• Use pain relievers. Try nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce pain and inflammation. NSAIDs come in pills and also in  cream form that you can rub over the sore area. Acetaminophen can also help with pain. Do not rely on medicine to relieve pain so you can keep overusing the joint.
• Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move the joint through its full range of motion, even during times that you are resting the joint area. This will prevent stiffness. As the pain goes away, add other exercises to strengthen the muscles around your joint.
• Avoid tobacco smoke. Smoking delays wound and tissue healing.

Sometimes the fluid in the bursa can get infected. If this happens, you may need antibiotics.

Bursitis is likely to improve in a few days or weeks if you rest and treat the affected area. It may return if you don’t stretch and strengthen the muscles around the joint and change the way you do some activities.

You may be able to prevent bursitis from happening or coming back. Some ways include:

• Continue your home treatment with rest, ice, pain relievers and gentle exercises.
• When you are ready to try the activity that caused the pain, start slowly and do it for short periods or at a slower speed. Warm up before and stretch after the activity. Increase your activity slowly, and stop if it hurts. Use ice after to prevent pain and swelling.
• Change the way you do activities with repeated movements that may strain your muscles or joints. For example, if sitting for long periods caused bursitis, get up and walk around every hour.
• Protect your joints from pressure. Cushion knees or elbows on hard surfaces, and wear shoes that fit well and provide good support.