Bursitis
Bursitis is the inflammation of the bursa, which is a fluid-filled sac that is found between a tendon and bone. Bursae are found near joints where the tendons and muscles overlie bony projections. Bursae assist in the movement of the joints, and in turn reduce friction in moving joints. Bursitis is a common cause of pain in the shoulders, hips, elbows and knees. Bursitis can be chronic or acute.
Figure 1: Hip Bursa
WHAT CAUSES BURSITIS?
Bursitis can be caused by overuse or trauma. Trauma causes inflammatory bursitis from repetitive injury. Repetitive motion, such as throwing a baseball or repetitive kneeling can lead to chronic bursitis. Bursitis can also develop in patients with underlying conditions such as gout, osteoarthritis and rheumatoid arthritis. Often times the cause cannot be determined.
SYMPTOMS:
Patients will have tenderness when pressing around the joint. Most patients complain of aching and stiffness during joint movement and may notice areas of swelling over the affected areas. Bursitis causes pain around the affected bone or tendon.
Figure 2: Areas Bursitis Affects
TREATMENT OPTIONS:
Temporary rest of the affected joint, followed by proper exercises under the direction of physical therapy is helpful. Ice is often times applied directly over the affected area to reduce inflammation. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as naproxen and ibuprofen can be helpful in relieving inflammation and pain. These medications are not for everybody, and one should consult their doctor to make sure that these drugs are not contraindicated. If the inflammation does not respond to the above initial treatments, it may be necessary to inject corticosteroids directly into the bursa affected. Too many steroid injections over a short period can cause injury to the area involved and possibly muscle atrophy. Surgery is not often required, but in rare cases, an infected bursa may need to be drained surgically.
Figure 3: Bursa Injection
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