Bursitis

Bursitis is the inflammation of one or more bursae, or small sacs of synovial fluid, in the body. Bursae rest at the points where internal functionaries, like muscles and tendons, slide across bone. Healthy bursae create a smooth and almost frictionless gliding surface. With hundreds of them throughout the body they provide this surface for all motion, making movement normally painless. When bursitis takes hold, however, movement that relies on the inflamed bursa becomes rough and painful. Movement of tendons and muscles over the inflamed bursa causes it to become more inflamed, perpetuating the problem.

You have more than 150 bursae in your body. These small, fluid-filled sacs lubricate and cushion pressure points between your bones and the tendons and muscles near your joints. They help your joints move with ease. Bursitis occurs when a bursa becomes inflamed. When inflammation occurs, movement or pressure is painful.

Bursitis often affects the joints in your shoulders, elbows or hips. But you can also have bursitis by your knee, heel and the base of your big toe. Bursitis pain usually goes away within a few weeks or so with proper treatment, but recurrent flare-ups of bursitis are common.

Causes:

Bursitis is commonly caused by repetition of movement or excessive pressure. Elbows and knees are the most commonly affected because they are rested upon more than many parts of the body with bursae and they also get the most repetitive use. Inflammation of bursae can also be caused by other inflammatory conditions such as rheumatoid arthritis. Scoliosis can also be a cause of bursitis of the shoulders although this is rare. Shoulder bursitis is more commonly due to overuse of the shoulder joint and muscles.

The other main cause of bursitis is traumatic injury, which can cause swelling of the bursae. The swelling itself causes irritation because the sac will no longer fit in the small area between the bone and the functionary. When the bone begins to increase pressure on the bursa, bursitis ensues.

Symptoms:

If you have bursitis, you may notice:

* A dull ache or stiffness in the area around your elbow, hip, knee, shoulder, big toe or other joints.
* A worsening of pain with movement or pressure.
* An area that feels swollen or warm to the touch.
* Occasional skin redness in the area of the inflamed bursa.

Bursitis of the hip doesn't cause any visible swelling or skin redness because the bursae are located beneath some of your body's bulkiest muscles. In this type of bursitis, pain is primarily over the greater trochanter, a portion of your thighbone (femur) that juts out just below where the bone joins the hip.

Diagnosis:

Your doctor may have you undergo a physical examination and ask you about your recent activities. By feeling the painful joint and surrounding area, your doctor may be able to identify a specific area of tenderness.

If it appears that something else may be causing the discomfort, your physician may request an X-ray of the affected area. If bursitis is the cause, X-ray images can't positively establish the diagnosis, but they can help to exclude other causes of your discomfort.

Although you usually can trace bursitis to events of overuse or pressure, there may be no obvious cause. In the latter case, your doctor may want to perform additional screening to rule out other causes of joint inflammation and pain. This may include blood tests or an analysis of fluid from the inflamed bursa.

Treatment:

Bursitis treatment is usually simple and includes:

* Resting and immobilizing the affected area.
* Applying ice to reduce swelling.
* Taking Non Steroidal Anti-Inflammatory Drugs (NSAIDs) to relieve pain and to reduce the inflammation.

With simple self-care and home treatment, bursitis usually disappears within a couple of weeks.
Sometimes, your doctor may recommend physical therapy or exercises to strengthen the muscles in the area. Additionally, your doctor may inject a corticosteroid drug into the bursa to relieve inflammation. This treatment generally brings immediate relief and, in many cases, one injection is all you'll need.

If your bursitis is caused by an infection, you'll need to take antibiotics. Sometimes the bursa must be surgically drained, but only rarely is surgical removal of the affected bursa necessary.