Bursitis: when little sacs of joint lubricant become inflamed

Temporary pain caused by bursitis usually can be alleviated by a change of routine and other self-help remedies. Here's how.

In the parts of your body where tendons, ligaments, skin, muscles and/or bones rub against one another, small sacs of fluid provide cushioning and lubrication. Repetitive movements or frequent pressure on joints can cause a swelling of these sacs, called bursae (plural of bursa). The result is a painful condition – usually temporary – known as bursitis.

Parts of the body where bursitis occurs

The most common areas that can become inflamed are the knee, elbow, shoulder, hip, heel and ankle. Individuals who spend a lot of time on their knees -- carpet layers, roofers, hobbyist gardeners -- can develop bursitis in them. Many sports activities – throwing a baseball, swinging a tennis racket -- can lead to bursitis in the elbow and shoulder. Running and jogging can produce bursitis of the hip, heel and ankle. Even the way you sleep and the type of mattress you use can be a problem. Other, more serious forms of the malady can be caused by arthritis or infection. Symptoms range from aching and stiffness to a burning sensation at the joint.

Video: Bursitis

Self-help is usually enough to repair the damage

On rare occasions, surgery to drain or completely remove a damaged bursa may be required. However, for most people, self-help is often enough to relieve pain and reduce swelling, and usually within three weeks. Techniques include:

• Avoiding further activity or pressure on the affected area.
• Applying ice or cold packs.
• Taking over-the-counter pain relievers such as aspirin, ibuprofen and naproxen.

Treatment that a physician is likely to offer

If the pain persists after you take those steps, talk to your doctor. His or her approach could start with use of a brace to support and protect the bursa. A next step would be to drain some fluid from the bursa and test it for infection, which can be treated with antibiotics. (Fever is one sign of infection; other signs are warmth or redness around the joint and severe tenderness.) Your doctor may suggest physical therapy. He or she may use ultrasound to increase circulation and soften scar tissue. Injections of cortisone also can help.

A few more words about cortisone

Cortisone, a type of steroid, is a powerful anti-inflammatory medication. Cortisone injections usually work within a few days, and the beneficial effects can last for several weeks. There are side-effects to be considered. Cortisone flare is a condition where the injected cortisone crystallizes and causes pain worse than that of the bursitis. This usually lasts only a day or two. Cortisone is caustic. It can weaken tendons and soften cartilage tissue surrounding the joint. Repeated injections multiply these effects. Therefore, many physicians place a limit on the injections they will give a patient -- often not more than three or more frequently than one every three months.

Video: Shoulder Loosener #2

Preventing bursitis is an easy thing to do

Prevention of bursitis requires regular stretching exercises, which lengthen tendon connections near the bursae and reduce stiffness. Maintaining good overall physical condition is wise. If you're overweight, losing some pounds can help. Explore how you may be able to improve ergonomics on your job. Protect your joints from pressure by using knee cushions, for example. Wear shoes that offer good support for the activity and that fit you well. You can relieve pressure on joints while sleeping by using a soft bed topper or a memory-foam mattress.