What is Bursitis?

Bursitis
Definition
Whether at work or at play, if you overuse or repetitively add stress to your body’s joints, you may eventually develop a painful inflammation called bursitis.

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

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

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
• An increase 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.

Causes
Common causes of bursitis are attributed to the overuse, stress and direct trauma to a joint, such as with repeated bumping or prolonged pressure from kneeling. Bursitis may also result from an infection, arthritis or gout. However many times, the cause is unknown.

Bursitis in certain locations of your body is caused by repetitive motion related to certain activities:

• Shoulder. Bursitis of the shoulder often results from injury to the rotator cuff, the muscles and tendons that connect your upper arm bone to your shoulder blade. Causes of the injury may include falling, lifting and repetitive overhead arm activities. Sometimes it’s hard to distinguish between the pain caused by bursitis and that caused by a rotator cuff injury.
• Elbow. This type of bursitis is associated with actions requiring you to repeatedly bend and extend your elbow. You may get such an inflammation by doing common activities such as pushing a vacuum cleaner back and forth, or could be sports related such as throwing a baseball, swinging a tennis racket or a golf club. Even simply repeated leaning on your elbows could lead to bursitis over the tip of your elbow.
• Buttocks. This type of bursitis describes an inflamed bursa over the bone in your buttocks. It may result from sitting on a hard surface for long periods, such as on a bike.
• Hip. Bursitis of the hip is frequently associated with arthritis or a hip injury. The pressure from standing or sitting for a prolonged time also may lead to bursitis of the hip.
• Knee. In this form of bursitis, a soft, egg-shaped bump occurs on the front of your knee, the result of repetitive kneeling while installing tiles, scrubbing a floor, gardening or doing other activities that place pressure on your knees. A sharp blow to the knee can cause inflammation of the bursae around the kneecap. People with arthritis who are overweight often develop bursitis of the knee.
• Ankle. Inflammation of the bursa in the ankle commonly occurs as a result of improper footwear or prolonged walking or in sports, such as ice-skating.
  You may not be able to pinpoint a specific incident or activity that led to your bursitis. In some cases, the inflammation may stem from a staphylococcal infection.

Risk factorsIf you work in a profession or have a hobby that requires repetitive motion, you’re at an increased risk of developing bursitis. The occurrence of bursitis becomes more common in middle age as your body gets older. In addition, certain diseases and conditions increase your risk of developing bursitis, such as:

• Arthritis
• Gout
• Staphylococcal infection

When to seek medical advice
Most often bursitis responds well to home treatment. However, consult your doctor if:

• Bursitis pain is disabling or doesn’t subside after two weeks of home treatment
• You notice excessive swelling, redness, bruising or a rash in the affected area
• Pain is sharp or shooting, especially when you exercise or exert yourself
• You have a fever
• You have other medical conditions that may increase your risk of an infection, such as diabetes, rheumatoid arthritis or an autoimmune disease, such as lupus
• You take medications that increase your risk of infection, such as corticosteroids or immunosuppressants

Tests and diagnosis
Your doctor may have you undergo a physical examination and ask you about your recent activities. By feeling around the inflamed 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.

Treatments and drugs
Bursitis treatment is usually simple and includes:

• Resting and immobilizing the affected area
• Applying ice to reduce swelling
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation

By applying simple self-care and home treatment, bursitis will usually disappear within a couple of weeks.

Sometimes, your doctor may recommend physical therapy or exercises to strengthen the muscles in the area to avoid future inflammation in that 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.

Prevention
To help prevent bursitis or reduce the severity of flare-ups:

• Stretch your muscles. Warm up or stretch before and after physical activities.
• Strengthen your muscles. Strengthening can help protect your joints. Wait until the pain and inflammation are gone before starting to exercise a joint that has bursitis.
• Take frequent breaks from repetitive tasks. Alternate repetitive tasks with rest or other activities.
• Cushion your joint. Use cushioned chairs, foam for kneeling or elbow pads. Avoid resting your elbows on hard surfaces. Avoid shoes that don’t fit properly or that have worn-down heels.
• Don’t sit still for long periods. Get up and move about frequently.
• Practice good posture. For example, avoid leaning on your elbows.

If your bursitis is caused by a chronic underlying condition, such as arthritis, it may recur despite these preventive measures.

Lifestyle and home remedies
For taking care of bursitis at home:

• Take nonsteroidal anti-inflammatory drugs (NSAIDs). NSAIDs such as aspirin, ibuprofen (Advil, Motrin, others) or naproxen sodium (Aleve) can provide relief. Use as directed. Consult your doctor if you need NSAIDs for an extended period of time.
• Apply ice packs. Use them for 20 minutes several times a day during the first few days, or for as long as the joint area is warm to the touch.
• Apply heat. Use heat after the affected joint is no longer warm or red to help relieve muscle and joint pain and stiffness. But don’t overdo it. Don’t apply heat for more than 20 minutes at a time.

Sometimes moist heat seems to penetrate deeper and give you more relief than does dry heat.

• Perform stretching exercises. Stretching can help restore full range of motion.
• Elevate the affected joint. Raising your knee or elbow can help reduce swelling.
• Keep pressure off your joint. If possible, use an elastic bandage, sling or soft foam pad to protect a joint until the swelling goes down.

Source: http://www.mayoclinic.com/health/bursitis/DS00032/DSECTION=treatments-and-drugs