Bursitis

Bursitis usually causes a dull pain, tenderness, and stiffness near the affected bursa. The bursa may swell and make the skin around it red and warm to the touch. Bursitis is most common in the shoulder, elbow, hip, and knee. It may also occur near the Achilles tendon or in the foot.

Bursitis is commonly caused by:

• Overuse and repeated movements. These can include daily activities such as using tools, gardening, cooking, cleaning, and typing at a keyboard.
• Long periods of pressure on an area. For example, carpet layers, roofers, or gardeners who work on their knees all day can develop bursitis over the kneecap.
• Aging, which can cause the bursa to break down over time.
• Sudden injury, such as a blow to the elbow.

Bursitis can also be caused by other problems, such as arthritis or infection (septic bursitis).

Your doctor will ask about your past health and recent activities and examine the area. If your symptoms are severe or get worse even after treatment, you may need other tests. Your doctor may drain fluid from the bursa and test it for infection. Or you may need X-rays, an MRI, or an ultrasound.

Home treatment can help reduce pain and let the bursa heal. Here are ways you can care for yourself at home.

• Put ice or a cold pack on the area for 10 to 20 minutes at a time. Try to do this every 1 to 2 hours for the next 3 days (when you are awake) or until the swelling goes down. Put a thin cloth between the ice and your skin.
• After the 3 days of using ice, you may use heat on the area. You can use a hot water bottle; a warm, moist towel; or a heating pad set on low. You can also try alternating heat and ice.
• Rest the area where you have pain. Stop any activities that cause pain. Switch to activities that do not stress the area.
• Take pain medicines exactly as directed.
• If the doctor gave you a prescription medicine for pain, take it as prescribed.
• If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
• Do not take two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
• To prevent stiffness, gently move the joint as much as you can without pain every day. As the pain gets better, keep doing range-of-motion exercises. Ask your doctor for exercises that will make the muscles around the joint stronger. Do these as directed.
• You can slowly return to the activity that caused the pain, but do it with less effort until you can do it without pain or swelling. Be sure to warm up before and stretch after you do the activity.

Home treatment is often enough to reduce pain and let the bursa heal. This may include rest and icing the area.

Along with home care, your doctor may suggest physical therapy to strengthen the muscles around your joints.

If you have severe bursitis, your doctor may use a needle to remove extra fluid from the bursa. You might wear a pressure bandage on the area. Your doctor may also give you a shot of medicine to reduce swelling. Some people need surgery to drain or remove the bursa.

Sometimes the fluid in the bursa can get infected. If this happens, you may need antibiotics.