Is Bursitis Busting Up the Joint?

Pity the poor bursa. We have about 150 of these simple, fluid-filled sacs. Most of us have never heard of them until they start hurting.

Known all together as “bursae,” they protect and lubricate joints, reducing rubbing as bones, tendons, muscles and ligaments do their jobs. “Bursae vary in size,” says sports medicine physician Xander Arwand, DO, with Lehigh Valley Orthopedic Institute. “But many, like those in the shoulder, are about the size of a silver dollar.”

Bursae can become swollen and painful, a condition called bursitis. That makes simple movements of your shoulder, elbow, hip or knee seem like a huge effort.

“Overuse and the trauma of direct impact are the most common causes of bursitis,” says sports medicine physician Dimitry Belogorodsky, DO, with Lehigh Valley Orthopedic Institute. “As you age, you can injure bursae more easily. The sacs become drier over the years. Also, damage happens from wear and tear in and around your joints over time.”

“People often mistake bursitis for tendinitis,” Dr. Belogorodsky says. “In tendinitis, an inflamed tendon [a fibrous band tying muscle to bone] can cause joint pain.”

A softball player might suffer bursitis of the elbow or shoulder from repeated throwing, or in the knees from bending low to the ground to serve as a catcher.

Housework causes bursitis, too. For example, people who kneel to clean, garden or work on a roof are at risk for developing bursitis of the knee.

Experts say that prevention is better than treatment. “It’s important to listen to your body and not to overdo it when you feel pain or extreme tiredness,” Dr. Arwand says. If you’re kneeling to garden, for instance, you can help your knees by taking regular breaks and using a rubber pad as a cushion.

If you’re playing a sport, pay close attention to basic movements and seek quality coaching. You’ll be less likely to use poor mechanics and reduce your chance for injury.

You also can help prevent bursitis by stretching regularly.

Most bursitis goes away without medical attention in one to two weeks. Many people never realize that an inflamed bursa caused the pain.

Self-treatment of bursitis includes:

• Not doing the activity that led to pain.
• Using ice for the first 48 hours after an activity causes pain. Apply the ice wrapped in a towel for 15 to 20 minutes, three to four times a day. After a couple of days, use moist heat before physical activity and ice after activity if your primary care doctor or clinician agrees.
• Elevating the injury (when it’s possible and not painful) to reduce swelling.
• Taking over-the-counter anti-inflammatory medicines, such as ibuprofen and naproxen, for pain and swelling. Always consult with your primary care doctor or clinician before taking any over-the-counter medicines.

“If your pain is severe, doesn’t go away or interferes with daily activities, it may be time to see a doctor to rule out other causes,” Dr. Belogorodsky says.

A doctor diagnoses bursitis by putting your injured joint through a gentle range of motions and by pushing lightly on the skin above the painful joint. You may also need an X-ray.

Your doctor may prescribe stronger anti-inflammatory medicine or inject the injured bursa with cortisone to ease swelling and pain. Your doctor also may prescribe gentle exercise at home. This can improve blood flow to the joint and the bursa, and increase the range of motion.