Arthritis: Bursitis

What Is Bursitis?

Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

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.

Overuse or injury to the joint at work or play can also increase a person's risk. Examples of high-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. Incorrect posture at work or home and poor stretching or conditioning before exercise can also lead to bursitis.

An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) can put added stress on a bursa sac, causing bursitis. Stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions may also increase a person's risk. In addition, an infection can occasionally lead to inflammation of a bursa.

Who Usually Gets Bursitis?

Bursitis is more common in adults, especially in those over 40 years of age.

What Parts of the Body Does Bursitis Affect?

• Base of the thumb
• Elbow
• Shoulder
• Hip
• Knee
• Achilles tendon

What Are the Symptoms of Bursitis?

The most common symptom is pain at the site of the bursa and beyond. The pain may be a gradual buildup or sudden and severe, especially if calcium deposits are present. Loss of motion in the shoulder -- called "adhesive capsulitis" or frozen shoulder -- can also be a sign of bursitis.

How Can I Prevent Bursitis?

Bursitis can be prevented with a gradual buildup in activities, with limited force and limited repetitions. Stop what you are doing if unusual pain occurs. Try again later and if pain recurs, do not continue the activity that day.

How Is Bursitis Treated?

Bursitis can be treated in a number of ways, including:

• Avoiding activities that aggravate the problem.
• Resting the injured area.
• Icing the area the day of the injury.
• Taking over-the-counter anti-inflammatory medicines.

If the condition does not improve in a week, see your doctor.

Your doctor can also prescribe medications to reduce the inflammation. Corticosteroids, also known as "steroids," are often used because they work quickly to decrease the inflammation and pain. Steroids are also one of the safest treatment methods and can be injected directly at the site of injury. Unfortunately, 30% of people may not get complete relief from one injection and 2% of people may even get worse. Another disadvantage is that for recurrent cases, it is not safe to administer steroids frequently (more than every three months).

Physical therapy is another treatment option that is often used, especially for a frozen shoulder. This includes range of motion exercises and splinting (thumb, forearm, or bands).

Surgery, although rarely needed, may be an option when bursitis does not respond to the other treatment options.

Warning

Consult your doctor immediately if you have:

• Fever (over 100 Fahrenheit)
• Swelling, redness, and warmth
• General illness or multiple sites of pain
• Inability to move the affected area

These could be signs of another problem that needs more immediate attention.

Reviewed by the doctors at The Cleveland Clinic Department of Rheumatic and Immunologic Diseases