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Bursitis by Robert E. Leach, MD

Definition

Bursitis is inflammation of a bursa. A bursa is a thin, slippery piece of tissue that protects tendons. Tendons are the tissues that connect muscles to bones. The bursa reduces friction between the tendon and bone. It allows the tendon to glide easily over the bone.

There are many bursae in the body protecting underlying tendons. Bursitis most often occurs in the following joints:

Shoulder
Elbow
Knee
Hip

Bursitis in the Shoulder

Causes

Acute bursitis may be caused by:

A blow to an area containing a bursa
Overexertion of a joint (eg, swimming a long distance or throwing a ball many times)

Chronic bursitis is usually caused by long-term overuse. The repeated motion of a muscle-tendon unit causes friction in the bursa. As the activity continues, the bursa becomes inflamed. It may fill with fluid. The bursa thickens and does not function well. Both bursa and tendon may become irritated.

Risk Factors

Factors that increase your chance for bursitis include:

Repetitive motion activities when done to an extreme (eg, swimming, running, or tennis)
Contact sports
Sporting gear that does not fit well

Symptoms

Symptoms of bursitis include:

Pain in the area of the bursa
Swelling
Reddened skin
Warmth around the area of the bursa
Decreased motion of the nearby joint
Decreased function of the nearby limb

Diagnosis

The doctor will ask about your symptoms and your physical activities. The painful area will be examined. You may have an x-ray.

Treatment

Acute bursitis treatment may include some of the following:

Resting the affected area
Icing the painful area
Taking anti-inflammatory medications
Having a cortisone injection
Protecting the area from trauma

Treatment for chronic bursitis may include:

Stopping the activity causing pain
Taking anti-inflammatory medications
Protecting the bursa from trauma
Having physical therapy, including exercising and applying heat
Having a cortisone injection
Undergoing surgery

Prevention

The following steps may help to prevent bursitis:

Do not overdo sports and other activities.
When doing a new activity, gradually increase the length of time you do it.
Make sure you perform activities correctly.
Wear protective pads if you play contact sports.

RESOURCES:

American Academy of Orthopaedic Surgeons http://www.aaos.org/
American Orthopaedic Society for Sports Medicine http://www.aossm.org/

CANADIAN RESOURCES:

Canadian Orthopaedic Association http://www.coa-aco.org/
Canadian Orthopaedic Foundation http://www.canorth.org/

References:

American Academy of Orthopaedic Surgeons website. Available at: http://www.aaos.org/ .
Human Tendons: Anatomy, Physiology, and Pathology . Lippincott, Williams, and Wilkins; 1997.

Last reviewed July 2010 by Rosalyn Carson-DeWitt, MD

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