A bursa is a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons, or skin. Bursitis occurs when a bursa becomes inflamed. People get bursitis by overusing a joint. It can also be caused by an injury. It usually occurs at the knee or elbow. Kneeling or leaning your elbows on a hard surface for a long time can make bursitis start. Doing the same kinds of movements every day or putting stress on joints increases your risk.

Symptoms of bursitis include pain and swelling. Your doctor will diagnose bursitis with a physical exam and tests such as x-rays and MRIs. He or she may also take fluid from the swollen area to be sure the problem isn't an infection.

Treatment of bursitis includes rest, pain medicines, or ice. If there is no improvement, your doctor may inject a drug into the area around the swollen bursa. If the joint still does not improve after 6 to 12 months, you may need surgery to repair damage and relieve pressure on the bursa.

Bursitis is a common condition that causes swelling and pain around muscles and bones. Bursitis is the swelling of the bursa, a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons, or skin.

Points To Remember About Bursitis

• Bursitis is swelling in the bursa, a small, fluid-filled sac that cushions the bones and other body parts.
• Bursitis is typically caused by repetitive movements that hurt the bursae over time.
• To reduce risk of bursitis, don’t sit still for long periods of time, cushion your joints when kneeling or putting pressure on your elbows, and take frequent breaks from repetitive tasks.
• Bursitis is usually treated with rest, gentle exercise, and medication, but some severe cases may require surgery.

A few synovial joints of the body have a fibrocartilage structure located between the articulating bones. This is called an articular disc, which is generally small and oval-shaped, or a meniscus, which is larger and C-shaped. These structures can serve several functions, depending on the specific joint. In some places, an articular disc may act to strongly unite the bones of the joint to each other. Examples of this include the articular discs found at the sternoclavicular joint or between the distal ends of the radius and ulna bones. At other synovial joints, the disc can provide shock absorption and cushioning between the bones, which is the function of each meniscus within the knee joint. Finally, an articular disc can serve to smooth the movements between the articulating bones, as seen at the temporomandibular joint. Some synovial joints also have a fat pad, which can serve as a cushion between the bones.

Additional structures located outside of a synovial joint serve to prevent friction between the bones of the joint and the overlying muscle tendons or skin. A bursa (plural = bursae) is a thin connective tissue sac filled with lubricating liquid. They are located in regions where skin, ligaments, muscles, or muscle tendons can rub against each other, usually near a body joint (image). Bursae reduce friction by separating the adjacent structures, preventing them from rubbing directly against each other. Bursae are classified by their location. A subcutaneous bursa is located between the skin and an underlying bone. It allows skin to move smoothly over the bone. Examples include the prepatellar bursa located over the kneecap and the olecranon bursa at the tip of the elbow. A submuscular bursa is found between a muscle and an underlying bone, or between adjacent muscles. These prevent rubbing of the muscle during movements. A large submuscular bursa, the trochanteric bursa, is found at the lateral hip, between the greater trochanter of the femur and the overlying gluteus maximus muscle. A subtendinous bursa is found between a tendon and a bone. Examples include the subacromial bursa that protects the tendon of shoulder muscle as it passes under the acromion of the scapula, and the suprapatellar bursa that separates the tendon of the large anterior thigh muscle from the distal femur just above the knee.

A tendon sheath is similar in structure to a bursa, but smaller. It is a connective tissue sac that surrounds a muscle tendon at places where the tendon crosses a joint. It contains a lubricating fluid that allows for smooth motions of the tendon during muscle contraction and joint movements.

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Bursitis
Bursitis is the inflammation of a bursa near a joint. This will cause pain, swelling, or tenderness of the bursa and surrounding area, and may also result in joint stiffness. Bursitis is most commonly associated with the bursae found at or near the shoulder, hip, knee, or elbow joints. At the shoulder, subacromial bursitis may occur in the bursa that separates the acromion of the scapula from the tendon of a shoulder muscle as it passes deep to the acromion. In the hip region, trochanteric bursitis can occur in the bursa that overlies the greater trochanter of the femur, just below the lateral side of the hip. Ischial bursitis occurs in the bursa that separates the skin from the ischial tuberosity of the pelvis, the bony structure that is weight bearing when sitting. At the knee, inflammation and swelling of the bursa located between the skin and patella bone is prepatellar bursitis (“housemaid’s knee”), a condition more commonly seen today in roofers or floor and carpet installers who do not use knee pads. At the elbow, olecranon bursitis is inflammation of the bursa between the skin and olecranon process of the ulna. The olecranon forms the bony tip of the elbow, and bursitis here is also known as “student’s elbow.”

Bursitis can be either acute (lasting only a few days) or chronic. It can arise from muscle overuse, trauma, excessive or prolonged pressure on the skin, rheumatoid arthritis, gout, or infection of the joint. Repeated acute episodes of bursitis can result in a chronic condition. Treatments for the disorder include antibiotics if the bursitis is caused by an infection, or anti-inflammatory agents, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids if the bursitis is due to trauma or overuse. Chronic bursitis may require that fluid be drained, but additional surgery is usually not required.

You are more likely to get bursitis if you do the same kinds of movements every day or put stress on your joints. People like carpenters, gardeners, musicians, and athletes often get bursitis. Infection, arthritis, gout, thyroid disease, and diabetes can also cause bursitis. Bursitis is more likely the older you get.

Bursitis is usually caused by overusing a joint, but it can also be caused by direct trauma. Kneeling or leaning your elbows on a hard surface for a long time can make you more likely to get bursitis.

Bursitis causes swelling and pain around muscles and bones, especially around joints. Bursae are found throughout the body, but bursitis is most common in shoulders, elbows, wrists, hips, knees, and ankles.

To diagnose bursitis, your doctor will probably ask questions about your medical history and conduct a physical examination. Your doctor will probably ask you to describe your pain and will ask when and where you hurt and whether anything makes the pain better or worse.

Your doctor may also do other tests, such as:

• Touching the joint to see whether the tendons, which are another part of your joints, are swollen.
• X-rays, which do not show the bursae, but can help rule out other problems.
• A magnetic resonance imaging (MRI) test, which can show whether the bursae is swollen.
• Taking fluid from the swollen area to test for an infection.

Treating bursitis can reduce pain and swelling. Some common treatments include:

• Resting and elevating the injured area.
• Limiting your activity, in order to reduce further injury.
• Taking medicines that will reduce swelling, such as aspirin, naproxen, or ibuprofen.
• Gentle stretching and strengthening exercises.
• Applying compression to the injured area.
• Putting a brace, splint, or band on the injured joint.

If an infection is causing your bursitis, your doctor will probably prescribe antibiotics. Your doctor may also recommend ice for sudden, severe injuries, but most cases of bursitis are long term, and ice does not help.

If your bursitis does not improve, your doctor may inject a corticosteroid medicine into the area surrounding the inflamed bursa. Although these injections are common, they must be used with caution because they can lead to weakening or rupture of tendons. If your bursitis does not improve after 6 months to a year, your doctor may recommend surgery to repair damage and relieve pressure on your bursae.

Several types of health care professionals may treat you, including:

• A primary care physician.
• Physical therapists, who help to improve joint function.
• Orthopaedists, who treat and perform surgery for bone and joint diseases.
• Rheumatologists, who treat arthritis and other disease of the bones, joints, and muscles.

Bursitis typically happens when a person overuses their joints. Here are some tips to protect your joints:

• Exercise regularly.
• Start new activities or exercise regimens slowly, so you can see if an exercise is putting too much stress on your joints.
• Take breaks from repetitive tasks often.
• Use two hands to hold heavy tools, and use a two-handed backhand in tennis.
• Don’t sit still for long periods.
• Practice good posture throughout the day.