Bursitis is a common and painful condition caused by inflammation of the bursae. These are fluid-filled sacs that cushion and lubricate the bones and soft tissues around the joints. They reduce friction and make joints move easily. The condition is most likely to occur in people who perform jobs or activities, e.g., sports, that require repetitive use or movement of the joints.
When a bursa is inflamed, it causes pain, swelling, tenderness, and difficulty moving. Body parts commonly affected are the shoulders, elbows, hips, thighs, buttocks, knees, and ankle. Pain is usually felt at the site of the inflammation. A fever may develop if the condition is related to an infection.
Bursitis can be treated at home if the symptoms are not severe. Self-care treatment includes using ice packs, resting the affected area, and taking painkillers to relieve pain and reduce inflammation. Your neighborhood pharmacist may even recommend over-the-counter treatment.
When symptoms are severe, medical treatment may be necessary. You should see a doctor if you experience sharp shooting pain, develop a fever, the pain persists longer than 2 weeks, or there is excessive swelling or redness of the affected area.
Your doctor will be able to make an accurate diagnosis by performing a physical examination and asking you related questions. If further investigation is required, other tests may be done. They include blood tests or an X-ray, CT scan or MRI scan. A positive diagnosis will require medical treatment.
Antibiotics may be prescribed to treat bursitis if it is associated with a bacterial infection. Steroids or local anesthetic may be prescribed to treat chronic inflammation and pain.
Understanding the causes of bursitis may be useful in helping you decide when to seek medical attention.
1. Jobs where kneeling is involved
The knee is surrounded by three major bursae. They are the prepatellar bursa, located over the kneecap bone, the infrapatellar bursa under the knee cap, and the anserine bursa at the lower aide of the knee below the joint. When any of them become inflamed due to trauma from prolonged kneeling it causes knee bursitis.
Jobs where kneeling is involved is one of the most common causes of bursitis. Knee bursitis is nicknamed “Housemaids Knee,” “Miners Knee,” “Roofer’s Knee,” and “Carpet Layer’s Knee.” And for good reasons. Housekeepers spend a lot of time on their knees scrubbing floors.
Miners also spend a lot of time squatting and kneeling. So do people who install floorings, construction workers, mechanics, certain athletes, and dancers. Their work or activities involve repetitive kneeling or placing pressure on the knee frequently.
Knee bursitis in people with jobs where kneeling is involved can be treated with antibiotics if the condition is caused by a bacterial infection. Local cortisone injections may be needed to reduce inflammation of the bursae. In severe cases, your doctor may aspirate or drain fluid from the affected site. Physical therapy also helps alleviate pain, strengthen knee muscles, and improve flexibility and can reduce recurrence of inflammation of the knee bursae.
2. Excessive Use
Excessive use or an overuse of joints can cause bursitis. Excessive use may come from prolonged pressing on a certain joint, such as from kneeling or sitting on a hard surface. It can also result from playing a sport that requires repetitive motions using a particular joint, such as the shoulder joint when throwing a baseball.
Repeated bending of the elbow, e.g., while playing tennis can cause elbow bursitis while repeatedly reaching upwards or lifting overhead can cause inflammation in the shoulder.
People middle-aged and older as well as athletes are more likely to be affected by bursitis due to excessive use of joints.
3. Direct impact
Chronic inflammation of the bursae can occur due to trauma or injury to the joint from direct impact. Direct impact can occur to the shoulders, elbows, hips, buttocks or knees particularly due to a fall.
Direct impact is mainly the cause of acute bursitis. A direct blow, e.g., banging the knee or shoulder, may cause blood to leak into the bursa causing inflammation, swelling, and pain.
Injury or trauma to the joint commonly occurs from a direct hit during an accident or contact sports. Reduced range of motion is more likely to occur from direct impact to these joints.
4. Running
Running calls for repeated flexion of the hips and knees and pressure on the ankles from body weight. Consequently, running is often the cause of inflammation of bursae in the hips, knees, and ankles.
Long-distance runners especially may develop inflammation in the bursa located on the inner side of the knee below the knee joint. The hips may also become inflamed, all due to the repetitive motion of running.
Running uphill puts additional pressure on the ankle to push the body upwards, causing inflammation of the retrocalcaneal or ankle bursa. In addition to medication, physical therapy may help stretch and strengthen affected muscles.
5. Arthritis
People with arthritis have an increased risk of developing inflammation of the bursae and pain in the joint. Arthritis is a common condition where one or more of the joints become inflamed.
Rheumatoid arthritis is a common type of arthritis linked to bursitis. Rheumatoid arthritis occurs when cells in the synovial lining or the synovial cells become inflamed and swollen. These synovial cells also line the bursae.
People who are obese, have a family history of arthritis, or have a previous joint injury are more likely to develop arthritis. In overweight individuals, excess pressure is placed on the knee and hips.
6. Sports with excessive impact
Certain sports involve direct or excessive impact. Some sports with excessive impact are particularly football and wrestling. Direct blows to the shoulders is common in football when tackling or blocking, despite protective gear.
Volleyball and athletic running are other sports with excess impact. Knee bursitis is common among volleyball players and sprinters or long-distance runners. Repetitive movement of the knee increase the risk inflammation of the bursa located on the inner side of the knee below the joint.
Direct and excessive impact from frequently falling on the knee also makes it easier for the bursa in the knee cap to inflame.
7. Falling
Falling makes any of the main joints to be vulnerable to developing bursitis. The buttock, shoulder, hip, elbow, and knee are more easily injured from falling. Direct impact from falling or trying to break a fall may result in trauma or injury that causes blood seepage from bruised or broken blood vessels.
This can result in inflammation of the bursae around these joints. Falling and landing on the knee can result in acute compression of the prepatellar or knee bursa. Athletes and runners are more predisposed to falling and developing pain and inflammation of the bursae.
8. Gout
Gout is another cause of bursitis and results in severe joint pain. When it occurs, it is called “gouty bursitis.” Gout occurs when uric acid crystalizes due to high levels of the acid in the body. It normally crystalizes in joints and surrounding soft tissues which can result in inflammation of the bursae.
Studies show that people with gout have an increased risk of developing bursitis. In the treatment of bursitis due to gout, your doctor will need to treat you separately for each condition. Gout treatment includes medication to improve removal of uric acid and NSAID’s to relieve pain.
9. Arthritis
People with arthritis have an increased risk of developing inflammation of the bursae and pain in the joint. Arthritis is a common condition where one or more of the joints become inflamed.
Rheumatoid arthritis is a common type of arthritis linked to bursitis. Rheumatoid arthritis occurs when cells in the synovial lining or the synovial cells become inflamed and swollen. These synovial cells also line the bursae.
People who are obese, have a family history of arthritis, or have a previous joint injury are more likely to develop arthritis. In overweight individuals, excess pressure is placed on the knee and hips.
