HealthInfo Aoraki South Canterbury

Bursitis

Mate pupuhi pūkoro wē

Bursitis is inflammation of a small fluid-filled sac that sits near one of your bones. These sacs are called bursae (plural) or bursa (singular), and they help to protect the tissues that slide over the bone when you move. The illustration shows the bursa in your shoulder. Inflammation here is called subacromial bursitis.

You have more than 150 bursae in your body. Common types of bursitis are subacromial bursitis, which causes shoulder pain, olecranon bursitis (student's elbow), which causes elbow pain, bursitis in your hip, which contributes to greater trochanteric pain syndrome, and prepatellar and infrapatellar bursitis (housemaid's knee), which cause pain in your knee.

Bursitis can happen if you:

• move a joint in the same way many times, such as when you throw a ball a lot
• put a lot of pressure on the area, such as kneeling or resting on your elbows
• have certain types or arthritis, like gout or rheumatoid arthritis
• have an injury near a bursa, such as a strained shoulder or an inflamed tendon
• have an infection, usually on your skin, that spreads to the bursa
• are overweight, which puts more strain on your joints.

Symptoms of bursitis

You may have bursitis if you have some of these symptoms around a joint:

• swelling
• redness
• pain, which may only happen when your joint is in certain positions
• stiffness
• heat.

If you also have a fever, or the redness or swelling happened very quickly, see your general practice team as soon as possible. You may have an infection.

Diagnosing bursitis

Your general practice team or physiotherapist will usually be able to diagnose bursitis from what you tell them and from looking at the area. They might send you for an ultrasound scan if the affected bursa is deeper in your body and difficult to feel. An X-ray will not help, as X-rays do not show soft tissue such as a bursa. They might need to use a needle to take a sample of fluid from the swelling if they think you have an infection or a type of arthritis. This fluid can help them make the right diagnosis.

Self-care for bursitis

The best way to help bursitis is to rest and protect the joint from pressure and repetitive movements. But do not stop moving the joint completely unless your general practice team or physiotherapist tells you to. If you do not move your joint at all, you could lose muscle and end up with scar tissue that could cause long-term stiffness in the joint.

Use pads or cushions to protect the painful joint. For example, use knee pads if your job involves a lot of kneeling.

Applying ice and heat can help to reduce the swelling and ease the pain. Ice tends to help more for hot, red, swollen areas. Put crushed ice in a damp towel and hold it against the bursa for 15 minutes.

Heat can help with deeper bursitis. For example, if it's in your hip. Use a hot water bottle or wheat bag and be careful not to burn your skin.

Your general practice team or physiotherapist may suggest that you take non-steroidal anti-inflammatory medication (NSAID) such as ibuprofen or naproxen for a short time, but will first check that you can take NSAIDs. You shouldn't take an NSAID for more than a couple of days without your general practice team's advice, and not at all if you have heart, kidney or stomach problems.

Treating bursitis

Your general practice team may decide to drain the bursa if it's very swollen and stops you from moving. Unfortunately, the fluid is likely to come back, and it is not good to keep draining the fluid as this increases your chances of getting an infection.

If the bursa is infected, you might need antibiotics.

Some types of bursitis can be treated with a steroid injection, which helps to get rid of the inflammation. But this doesn't work for all types of bursitis. Your general practice team or physiotherapist will know if this will help you.

A physiotherapist can also give you exercises that can help to stop or prevent injuries in the nearby tissues that might be causing the bursitis.

Written by HealthInfo clinical advisers. Last reviewed July 2022.

Sources

Page reference: 255218

Review key: HIBUR-255218