A bursa is a fluid-filled sac that reduces friction around your joints. When the bursa becomes inflamed (swollen) because the fluid inside is infected or irritated by too much movement, this is called bursitis. It causes pain, swelling and difficulty moving the affected joint.

When the condition called bursitis occurs, the normally slippery bursa becomes swollen and inflamed. The added bulk of the swollen bursa causes more friction within an already confined space. Also, the smooth gliding bursa becomes gritty and rough. Movement of an inflamed bursa is painful and irritating.

What Causes Bursitis?

This condition is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age they are able to tolerate stress less, are less elastic, and are easier to tear.

Acute: A direct blow (let’s say you accidentally bang your knee into a table) can cause blood to leak into the bursa. This rapid collection usually causes marked pain and swelling, most often in the knee.

Often there is an initial injury that sets off the process of inflammation. Thereafter, the problem can be self-exacerbating. Once there is an initial injury, the tendons and bursa become inflamed. This inflammation causes a thickening of these structures.

Symptoms of Bursitis

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

Bursitis symptoms vary from local joint pain and stiffness, to burning pain that surrounds the joint around the inflamed bursa. In this condition, the pain usually is worse during and after activity, and then the bursa and the surrounding joint become stiff the next day.

How is bursitis diagnosed?

Bursitis is typically identified by localized pain or swelling, tenderness, and pain with motion of the tissues in the affected area. X-ray testing can sometime detect calcifications in the bursa when bursitis has been chronic or recurrent.

Treatment of Bursitis

Most patients with bursitis are treated conservatively to reduce inflammation. Conservative treatment includes rest, cold and heat treatments, elevation, nonsteroidal anti-inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections (with or without local anesthetic agents).

The heat is on. Putting heat on the joint when it is no longer warm to the touch can reduce the pain. As with ice, don’t apply heat for more than 20 minutes at a time.
Elevation. Raising a joint that is swollen for any reason can help to reduce swelling. That goes for bursitis, too. If possible, elevate the affected joint so it is above the level of the heart.

Injection of a corticosteroid along with a local anesthetic may also be helpful in relieving symptoms of hip bursitis. This is a simple and effective treatment that can be done in the doctor’s office. It involves a single injection into the bursa. The injection typically provides permanent relief. If pain and inflammation return, another injection or two, given a few months apart, may be needed.

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