Bursitis: Symptoms, Diagnosis, Treatment, and Prevention

When it comes to musculoskeletal health, various ailments have the potential to disrupt daily life and hinder mobility, often manifesting as discomfort or pain in specific areas of the body. Among these, bursitis emerges as a prevalent yet often misunderstood condition, affecting individuals across various age groups and activity levels. With its nuanced presentation and potential impact on quality of life, understanding bursitis is paramount for effective management and relief. In this article, we explore the intricacies of bursitis, covering its causes, symptoms, diagnostic methods, and treatment options to equip readers with comprehensive insights into addressing this common yet often overlooked condition. Let’s start with the basics.

What is Bursitis?

Bursitis is a condition characterized by inflammation of the bursae, which are small, fluid-filled sacs located near joints. These sacs serve as cushions between bones, tendons, and muscles, reducing friction and allowing smooth movement of the joints. When the bursae become inflamed, usually due to repetitive movements, injury, or prolonged pressure on a specific area, it can lead to bursitis. Bursitis can occur in various parts of the body, such as the shoulder, elbow, hip, knee, and heel, and it can be acute (sudden onset) or chronic (long-lasting) depending on the underlying cause and duration of inflammation.

What are the Types of Bursitis?

Bursitis can affect various parts of the body, and the specific type of bursitis is often named after the affected area. Some common types of bursitis include:

• Shoulder bursitis: Also known as subacromial bursitis or shoulder impingement syndrome, this type of bursitis affects the bursa located between the rotator cuff tendons and the acromion (a bony prominence on the shoulder blade).
• Elbow bursitis: Commonly referred to as olecranon bursitis, this condition involves inflammation of the bursa located at the tip of the elbow, known as the olecranon bursa.
• Hip bursitis: Also called trochanteric bursitis, this type of bursitis affects the bursae located near the greater trochanter (a bony prominence on the side of the hip). It can cause pain and tenderness on the outer side of the hip.
• Knee bursitis: Knee bursitis can affect several bursae around the knee joint, including the prepatellar bursa (located in front of the kneecap), the infrapatellar bursa (below the kneecap), and the anserine bursa (on the inner side of the knee).
• Heel bursitis: Also known as retrocalcaneal bursitis or Achilles bursitis, this type of bursitis affects the bursa located between the Achilles tendon and the heel bone (calcaneus).
• Finger bursitis: Finger bursitis can occur in the fingers or thumbs, typically as a result of repetitive gripping or pressure. It may affect the bursae at the base of the fingers or thumbs.
• Toes bursitis: Bursitis can also affect the toes, particularly the big toe. This may involve inflammation of the bursa at the base of the big toe joint, known as bunion bursitis.

What are Bursitis Symptoms?

The symptoms of bursitis can vary depending on the location and severity of the condition. However, common symptoms of bursitis may include:

• Pain: Pain is a primary symptom of bursitis and is typically localized to the affected area. The pain may be dull, achy, or sharp and may worsen with movement or pressure on the affected joint.
• Swelling: Bursitis often leads to inflammation of the bursa, resulting in localized swelling around the affected joint. The swelling may be accompanied by redness and warmth in the area.
• Tenderness: The affected area may feel tender to the touch, and pressing on the bursa may elicit pain or discomfort.
• Limited range of motion: Bursitis can restrict the normal range of motion of the affected joint, making it difficult or painful to move the joint fully.
• Stiffness: Bursitis may cause stiffness in the affected joint, especially after periods of inactivity or prolonged rest.
• Warmth and redness: In some cases, the skin over the affected area may feel warm to the touch and appear red or inflamed.

It’s important to note that not everyone with bursitis will experience all of these symptoms, and the severity of symptoms can vary from person to person. Additionally, symptoms may worsen over time if bursitis is left untreated or if aggravating activities continue.

What Causes and Risk Factors of Bursitis?

Bursitis can develop due to a variety of factors, including:

• Repetitive motion: Activities or occupations that involve repetitive movements or prolonged pressure on a specific joint can irritate the bursae, leading to inflammation and bursitis. Examples include repetitive lifting, kneeling, or overhead reaching.
• Trauma or injury: Direct trauma or injury to a joint can cause inflammation of the bursa, leading to bursitis. This may occur due to a fall, blow, or impact to the affected area.
• Poor posture or body mechanics: Poor posture or improper body mechanics during physical activities can increase the risk of bursitis by placing excessive stress on the joints and surrounding structures. This can lead to inflammation and irritation of the bursae.
• Joint overuse: Overuse of a joint, such as engaging in intense physical activity without proper rest or recovery, can strain the bursae and contribute to bursitis development.
• Infection: In rare cases, bursitis can develop as a result of bacterial or fungal infection of the bursa. This is known as septic bursitis and requires prompt medical attention.
• Underlying medical conditions: Certain medical conditions, such as rheumatoid arthritis, gout, diabetes, and thyroid disorders, can increase the risk of developing bursitis. These conditions may predispose individuals to inflammation and joint problems.
• Age: As people age, the bursae may become less elastic and more prone to inflammation, increasing the risk of bursitis development.
• Obesity: Excess body weight can place increased stress on the joints, leading to inflammation of the bursae and an increased risk of bursitis.
• Sports activities: Certain sports activities, such as tennis, and baseball, which involve repetitive movements or frequent joint stress can increase the risk of bursitis.

It’s important to note that while these factors may increase the risk of developing bursitis, not everyone with these risk factors will develop the condition. Additionally, bursitis can occur in individuals without any known risk factors.

How is Bursitis Diagnosed?

Diagnosing bursitis typically involves a combination of medical history review, physical examination, and, in some cases, imaging studies or diagnostic tests. Here’s an overview of the diagnostic process for bursitis:

• Medical history review: The doctor will ask about your symptoms, medical history, and any recent injuries or activities that may have contributed to your symptoms. Providing detailed information about when your symptoms started, the location and severity of pain, and any factors that worsen or improve your symptoms can help guide the diagnostic process.
• Physical examination: During the physical examination, the doctor will assess the affected joint for signs of bursitis, such as swelling, tenderness, warmth, and limited range of motion. They may also perform specific maneuvers to reproduce your symptoms and evaluate joint function.
• Imaging studies: In some cases, imaging studies such as X-rays, ultrasound, or magnetic resonance imaging (MRI) may be ordered to visualize the affected joint and surrounding structures. These imaging studies can help rule out other conditions that may mimic bursitis, such as fractures, arthritis, or tendon injuries, and provide additional information about the extent of inflammation or fluid accumulation in the bursa.
• Laboratory tests: In cases of suspected septic bursitis (bursitis caused by bacterial or fungal infection), the fluid obtained during aspiration may be sent for laboratory testing to identify the causative organism and determine the appropriate treatment.

Based on the findings of the medical history, physical examination, and any diagnostic tests performed, the doctor makes a diagnosis of bursitis and develops a treatment plan tailored to the specific needs of the patient.

How is Bursitis Treated?

Treatment for bursitis typically focuses on relieving symptoms, reducing inflammation, and addressing the underlying cause of the condition. Depending on the severity and location of bursitis, treatment options may include:

• Rest and activity modification: Avoiding activities that exacerbate symptoms and giving the affected joint adequate rest can help reduce inflammation and promote healing. Modify activities to minimize repetitive motions or pressure on the affected area.
• Ice therapy: Applying ice packs to the affected joint for 15-20 minutes several times a day can help reduce pain and inflammation. Be sure to wrap the ice pack in a towel or cloth to protect the skin.
• Pain relief medications: Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve) can help reduce pain and inflammation associated with bursitis. Follow the dosage instructions and consult a healthcare provider if you have any concerns or medical conditions.
• Physical therapy: A physical therapist can provide exercises and stretches to improve flexibility, strength, and range of motion in the affected joint. Physical therapy may also include techniques such as ultrasound or massage to reduce inflammation and promote healing.
• Corticosteroid injections: In cases of persistent or severe bursitis, a healthcare provider may recommend corticosteroid injections into the affected bursa to reduce inflammation and alleviate pain. These injections are typically performed under ultrasound or fluoroscopic guidance for accuracy.
• Aspiration (fluid removal): If there is a significant amount of fluid accumulation in the bursa, the doctor may perform aspiration to remove the excess fluid and relieve pressure on the surrounding tissues. This procedure can help alleviate pain and improve mobility. In addition, the fluid may be sent to a laboratory for further evaluation to rule out infection or other underlying causes of bursitis.
• Immobilization: In some cases, using a splint, brace, or supportive device to immobilize the affected joint may be recommended to reduce stress on the bursa and promote healing.
• Antibiotics (for septic bursitis): If bursitis is caused by a bacterial infection (septic bursitis), treatment may include antibiotics to eradicate the infection. In severe cases, hospitalization and intravenous antibiotics may be necessary.
• Surgery (in rare cases): If conservative treatments fail to provide relief or if there is a persistent underlying problem such as a bone spur or chronic inflammation, surgical intervention to remove the affected bursa (bursectomy) may be considered as a last resort.

How to Prevent Bursitis?

Preventing bursitis involves taking proactive steps to reduce the risk of inflammation and injury to the bursae. Here are some strategies to help prevent bursitis:

• Maintain proper body mechanics: Practice good posture and body mechanics during physical activities, especially those that involve repetitive movements or prolonged pressure on joints. Avoid overexertion and use proper lifting techniques to minimize strain on the joints and surrounding tissues.
• Take regular breaks: If you engage in activities that require repetitive motions or prolonged pressure on joints, such as gardening or typing, take regular breaks to rest and stretch. Alternate tasks or change positions frequently to reduce stress on the same joints and muscles.
• Use protective equipment: When participating in sports or activities that pose a risk of injury, such as contact sports or construction work, wear appropriate protective gear, such as helmets, knee pads, or elbow pads, to cushion and support the joints.
• Gradually increase activity level: If you’re starting a new exercise program or increasing the intensity or duration of your workouts, do so gradually to allow your body to adapt and minimize the risk of overuse injuries. Incorporate rest days into your routine to give your joints time to recover.
• Stay active: Regular exercise can help strengthen muscles, improve flexibility, and maintain joint health, reducing the risk of bursitis and other musculoskeletal problems. Choose low-impact activities that are gentle on the joints, such as swimming, cycling, or walking, and incorporate strength training and flexibility exercises into your routine.
• Maintain a healthy weight: Excess body weight can place added stress on the joints, increasing the risk of bursitis and other joint-related conditions. Maintain a healthy weight through a balanced diet and regular exercise to reduce strain on the joints and promote overall health.
• Avoid repetitive movements: Minimize repetitive motions or activities that place repetitive stress on the same joints and muscles, especially if they cause discomfort or pain. Modify tasks or use ergonomic tools and equipment to reduce strain on the affected areas.
• Notice warning signs: Pay attention to your body’s signals and avoid pushing through pain or discomfort. If you experience persistent pain, swelling, or stiffness in a joint, take a break from activities that exacerbate your symptoms and consult a healthcare provider for evaluation and guidance.

By incorporating these preventive measures into your daily routine, you can help reduce the risk of bursitis and maintain healthy joints and musculoskeletal function over time.