Bursitis is inflammation of a bursa, a small fluid-filled sac that acts as a cushion between a bone and muscle, skin or tendon. The type of bursitis depends on the location of the affected bursa. This condition commonly affects the shoulder, elbow, hip, buttocks, knees and calf.
Bursitis and tendinitis often result from sports injuries or repetitive movements. But it can also be caused by:
- Bad posture or walking habits
- Stress on soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or joint deformities)
- Some types of arthritis and related conditions (rheumatoid arthritis, osteoarthritis and gout)
- Metabolic conditions such as diabetes
- Side effects from taking certain medications
Since the pain occurs near a joint, these conditions are sometimes mistaken for arthritis.
This condition causes inflammation, tenderness and pain in areas around a joint, such as the tendons, ligaments, bursae and muscles. Some conditions can occur suddenly, last for days or longer and usually resolve with rest or treatment. They can also re-occur in the same body area.
A primary care doctor can diagnose most soft tissue rheumatic conditions with a medical history and physical examination. If you experience persistent redness or swelling around the joints, as well as fever or chills, see a doctor immediately to make certain you don’t have an infection.
Bursitis and tendinitis may go away over time. If they don’t, the doctor will focus on reducing pain and inflammation and preserving mobility to prevent disability and recurrence. He or she may refer you to a rheumatologist, an orthopaedic surgeon or a physical therapist for specialized treatment, if necessary. When properly treated, most of these conditions don’t result in permanent joint damage or disability.
Common bursitis treatment options include:
Rest and Splints
Many soft tissue conditions are caused by muscle overuse, so the first treatment may include resting the painful area or avoiding a particular activity for a while. Splints, braces or slings allow a particular area to rest until the pain eases.
Hot and Cold Therapy
A cold compress can help reduce initial swelling and pain. Cold therapy is usually most effective during the first 48 hours after overuse, injury or swelling begins. After 48 hours or for chronic (long-term) pain, dry or moist heat (e.g., warm bath) may be more helpful than cold compresses.
Over-the-Counter and Prescription Medicines
These medicines help relieve pain and/or inflammation. The doctor may recommend an over-the-counter analgesic (pain reliever), such as acetaminophen or a nonsteroidal anti-inflammatory drug (NSAID), such as aspirin, ibuprofen or naproxen. Depending on the severity of the symptoms, doctors may prescribe a stronger version of an analgesic or NSAID.
Corticosteroids are powerful anti-inflammatory medicines. They are injected directly into a joint in a doctor’s office.
A physical therapist can provide the following:
- Hot/cold treatments, ultrasound (sound wave), laser and water therapy
- Soft tissue or joint mobilization (manual therapy)
- Orthotics or pressure-relieving devices for the arms and legs
- A personalized exercise program
- Analysis of posture and walking
- Education regarding appropriate activities to allow healing to occur
An occupational therapist can recommend modifications for daily activities and work habits to prevent re-injury. He can create hand and wrist splints and suggest assistive devices to help make daily activities easier.
One of the best ways to take care of bursitis or tendinitis is to take a proactive role in your own treatment – a process called self-management. Because these conditions are mostly caused by overuse, the best way to prevent them from re-occuring is to avoid or modify activities that cause the problem. A doctor, a physical therapist or occupational therapist can provide suggestions on modifying daily activities. Maintaining a healthy weight can help take pressure of painful and swollen joints. Range-of-motion exercises can help to improve flexibility and reduce stiffness.