Bursitis

Overview

Bursitis is a painful condition where the small, fluid-filled sacs (bursae) near joints become inflamed. It commonly affects the shoulder, elbow, hip, knee, heel, and the base of the big toe. Bursitis usually results from repetitive motions or positions that put pressure on the bursae. Symptoms include achy or stiff joints, pain when moving or pressing on the affected area, and swelling and redness. If you experience disabling joint pain, sudden inability to move a joint, excessive swelling, fever, or sharp/shooting pain, consult your doctor. Proper treatment typically involves resting the affected joint and protecting it from further trauma.

Understanding the disease

Risk Factors

Risk factors for developing bursitis include:

1. Age: Bursitis becomes more common with aging.
2. Occupations or hobbies: Engaging in jobs or hobbies that require repetitive motion or pressure on particular bursae can increase the risk of developing bursitis. Examples include carpet laying, tile setting, gardening, painting, and playing a musical instrument.
3. Other medical conditions: Certain systemic diseases and conditions, such as rheumatoid arthritis, gout, and diabetes, increase the risk of developing bursitis. Being overweight can also increase the risk of developing hip and knee bursitis.

Development

Bursitis develops when bursae, the small, fluid-filled sacs that cushion bones, tendons, and muscles near joints, become inflamed. Common causes of bursitis include repetitive motions or positions that put pressure on the bursae, injury or trauma to the affected area, and underlying medical conditions such as rheumatoid arthritis, gout, and infection. Additionally, age and certain occupations or hobbies that require repetitive motions or pressure on particular bursae can increase the risk of developing bursitis.

Assessment and Diagnosis

Diagnosis

Doctors can often diagnose bursitis based on a medical history and physical exam. Testing may include imaging tests, such as X-rays, ultrasound, or MRI, to help exclude other causes of discomfort. Blood tests or an analysis of fluid from the inflamed bursa might be ordered to pinpoint the cause of joint inflammation and pain. However, there's no specific test to diagnose bursitis, and the diagnosis is often made based on the combination of symptoms, medical history, and physical examination.

Management and Treatment

Complications

Potential complications of bursitis include recurrent flare-ups, chronic pain, and the development of associated conditions such as tendinitis or synovitis. In rare cases, untreated bursitis can lead to the rupture of the bursa, causing the release of bursal fluid and potential infection. Serious complications may arise in cases of bursitis due to infection or other systemic conditions. These can include septic bursitis, which can lead to the spread of infection to other parts of the body, and secondary complications associated with underlying conditions like rheumatoid arthritis or diabetes. It is essential to consult a doctor for proper diagnosis and treatment to prevent potential complications.

Treatment

Treatment for bursitis typically involves resting the affected joint and protecting it from further trauma. In most cases, bursitis pain goes away within a few weeks with proper treatment, but recurrent flare-ups of bursitis are common. Some additional treatment options include:

1. Over-the-counter pain relievers: You can take over-the-counter pain relievers, such as ibuprofen or acetaminophen, to help alleviate pain and reduce inflammation.
2. Physical therapy: A physical therapist can provide exercises to help strengthen the muscles around the affected joint, improve flexibility, and reduce pain.
3. Corticosteroid injections: In some cases, a healthcare professional may administer a corticosteroid injection directly into the affected bursa to reduce inflammation and pain.
4. Topical creams or ointments: Applying topical creams or ointments, such as capsaicin or menthol, to the affected area may help alleviate pain and reduce inflammation. It is essential to consult your doctor for a proper diagnosis and to determine the most appropriate treatment plan for your specific case.

Preparing for medical consultation

To prepare for an appointment for bursitis, you should:

1. Make a list of your symptoms and when they began.
2. Gather information about your medical history and your family's.
3. Create a list of all medications and dietary supplements you take, including doses.
4. Prepare a list of questions to ask your doctor, such as:
   • What is the most likely cause of my symptoms?
   • What are other possible causes?
   • What tests will I need?
   • What treatment approach do you recommend?
   • Will I need to limit my activities?
   • Have you any brochures or other printed material I can take? What websites do you recommend?
5. Note any recent exposure to possible sources of infection, such as traveling abroad.
6. Bring your vaccination record, if possible, to inform your doctor about your vaccination status.
7. Compile a list of your key medical information, including other conditions for which you're being treated and any medications, vitamins, or supplements you're currently taking. Remember to follow any pre-appointment restrictions or office visit instructions provided by your doctor, and be sure to attend the appointment wearing loose, comfortable clothing that allows for easy movement of the affected joint.