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Acute Bursitis

Acute Bursitis

What is bursitis? — Bursitis is a condition that can cause pain or swelling next to a joint. Most of the time, bursitis happens around the shoulder, elbow, hip, or knee. It can also happen around other joints in the body.
A "bursa" is a small fluid-filled sac that sits near a bone. It cushions and protects nearby tissues when they rub on or slide over bones. These sacs, called "bursae," are found in many places throughout the body (figure 1 and figure 2). Bursitis happens when a bursa gets irritated and swollen. This can happen when a person:
Moves a joint over and over again in the same way, over a short period of time
Sits on a hard surface or stays in a position that presses on the bursa for a long time
Has certain kinds of arthritis, such as gout or rheumatoid arthritis, that can affect their joints and bursae
Gets hurt near a bursa
Has an infection that spreads to a bursa
What are the symptoms of bursitis? — Symptoms of bursitis can include:
Pain or tenderness
Trouble moving the joint
A bursa can get infected if a person gets a cut on the skin nearby. An infected bursa can cause a fever and the area around the bursa to be:
If you have any of the symptoms of an infected bursa, let your doctor or nurse know as soon as possible.
Is there a test for bursitis? — Yes. Your doctor or nurse will ask about your symptoms and do an exam.
If you have symptoms of an infected bursa, your doctor might use a needle to remove some fluid from the bursa. Then he or she can do lab tests on the fluid to find out what is causing the bursitis, and if you need antibiotics.
He or she might also order imaging tests, such as an MRI scan or ultrasound. Imaging tests can create pictures of the inside of the body.
What can I do to treat my bursitis? — To treat your bursitis, you can:
Rest, cushion, and protect the area – Try not to irritate the area that hurts. For example, people with very painful shoulder bursitis might need to avoid lifting or carrying heavy things for a while. They might also need to wear an arm sling. People with bursitis behind the heel might need to use a thick heel pad. This can raise the heel so that it does not rub against the back of the shoe.
Avoid positions that put pressure on the area – For example, people with bursitis in the front of the knee should avoid kneeling.
Put ice on the area to reduce pain – Use a frozen bag of peas or a cold gel pack a few times a day for 20 minutes each time.
Put heat on the area to reduce pain and stiffness – Do not use heat for more than 20 minutes at a time. Also, do not use anything too hot that could burn your skin.
What other treatments might I have? — Your doctor or nurse might use other treatments, depending on your symptoms and where your bursitis is. Treatments can include:
Pain-relieving medicines called "nonsteroidal antiinflammatory drugs" or "NSAIDs" – NSAIDs include ibuprofen (sample brand names: Advil, Motrin), and naproxen (sample brand name: Aleve). These medicines can reduce pain and prevent the bursae from getting swollen and painful.
Steroid injections – Steroid medicines help reduce inflammation. These are not the same as the steroids some athletes take illegally. Doctors can inject steroids into the area of the bursitis to help reduce symptoms.
Exercises and stretches – Your doctor or nurse might recommend that you work with a physical therapist. A physical therapist can teach you stretches and exercises to help reduce your symptoms.
Surgery – A doctor can do surgery if other treatments do not work and you have had symptoms for a long time.
People with an infected bursa might also have treatment that includes:
Having the fluid in the bursa drained – A doctor can drain the fluid using a needle and syringe, or by doing surgery.
Can bursitis be prevented? — Yes. To help reduce the chance that you get bursitis, you can:
Use cushions or pads to avoid putting too much pressure on joints – For example, people who garden can kneel on a kneeling pad. People who sit for a long time can sit on a cushioned chair.
Take breaks, if you are using a certain joint too much
Stop an activity or change the way you are doing it, if you feel pain
Lose weight, if you are overweight
Use good posture
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 15727 Version 11.0
Release: 28.2.2 - C28.105
© 2020 UpToDate, Inc. and/or its affiliates. All rights reserved.

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