What is Bursitis?

There are over 150 bursae (bur-SEE) located throughout the human body, and each bursa contains a small amount of a jelly-like, lubricating substance.  Bursae are located between bones, tendons, joints, and muscles, including at the shoulders, elbows, hips, knees, and heels. In each location, bursae and serve as cushions to help lessen friction.

Bursitis (bur-SY-tis) is a fairly common condition that occurs when one or more of the bursae become irritated or inflamed, resulting in painful pressure or painful movement at the site.  The affected joint may feel stiff and achy and may look red and swollen.  The area may hurt more when you move or press on it.

The most common locations for bursitis are in the shoulder, hip, and elbow, although bursitis can also occur in the knee, ankle, buttocks, heel, and at the base of the big toe.  The inflammation of the bursae is often near a joint that is involved in frequent, repetitive motions, or at a position that applies pressure on the bursae at a particular joint.

When the elbow is affected by bursitis, it is commonly called , although it is not necessarily related to tennis.  In the U.S., between 1 and 3 percent of Americans will be affected, and half of all tennis players will experience tennis elbow, typically between 30 and 50 years of age.  Tennis elbow can also result from daily activities, such as sports activities with a high frequency of throwing.

Factors for Bursitis

• Overuse: Bursitis is commonly caused by repetitive stress (overuse) of an area, or by a sudden and more serious injury, such as overuse at work or during sports activities.
• High-risk activities for bursitis include gardening, raking, shoveling, carpentry, golf, tennis, throwing, pitching, and skiing. Swimming, gardening, and manual work involve repetitive turning or lifting of the wrist and thus typing, bricklaying or plumbing are also risk factors for bursitis.
• Age plays a role in bursitis, since aging tendons are less elastic, and are therefore less able to tolerate the physical stress and more likely to tear.
• Other health problems: Rheumatoid arthritis makes the bursae more likely to become inflamed.  Calcium deposits can occur within the tendons that attach muscles to the joints, and these deposits can cause friction and eventual bursitis.
• Previous surgery: Hip surgery or prosthetic implants in the hip may irritate the bursae and lead to bursitis.

Prevention

Follow these tips for time-honored approaches to lessen and prevent bursitis flare-ups:

• Lift properly, using kneeling pads as needed
• Wheel rather than carry heavy loads
• Give yourself frequent rest breaks
• Maintain a healthy weight or achieve a healthy weight
• Exercise
• Stretch with other warming-up exercises
• Use lighter-weight sports equipment or racquets with a larger grip size to help reduce strain on the tendons
• Use lighter-weight tools as needed

Treatments for Bursitis

Most patients respond well to nonsurgical management of bursitis using these approaches:

• Rest, which allows tears in the tendon attachment to heal.

• Making simple lifestyle changes by avoiding activities that worsen your symptoms.

• Limited use of nonsteroidal anti-inflammatory drugs (NSAIDS) such as ibuprofen, naproxen, celecoxib, and others, may relieve pain and control the inflammation of bursitis. Speak with your doctor about NSAIDS and any other medications that you may use.

• Steroid injection: Injection of a corticosteroid medication, along with a local anesthetic, can be helpful in relieving bursitis symptoms.  This injection is done in a doctor’s office and can provide temporary relief for months, and possibly permanent relief.  If the pain of bursitis returns, repeat injections given a few months apart may be needed.

However, the number of injections should be limited, since prolonged corticosteroid injections can damage surrounding tissues.  Steroids may also raise the patient’s blood pressure when used too long, and the risk of infection is increased with steroid use.

• Assistive devices: Use a walking cane or crutches for a week or longer as needed.

Surgical treatments:  In rare cases, when bursitis has not resolved within 6 to 12 months with nonsurgical treatment, surgery may be needed to remove the damaged part of a tendon in order to relieve the pain.  On a positive note, 80 to 95% of bursitis patients recover without surgery

Has the pain of bursitis interrupted your daily routine?  Our highly skilled physical therapists are here to help!  Call us at 1 (800) 481-4582 today.