Bursitis is inflammation and swelling of a bursa, which is the fluid-filled sac that surrounds a joint and cushions the tendons and bones.
When a bursa becomes inflamed it can no longer fit in the small area between the bone and the muscle or tendon, so it expands outwards, forming a fluid swelling under the skin around the joint.
A bursa that is inflamed but not infected can usually be successfully treated without surgery, using a combination of; resting, elevating and icing the joint; physiotherapy; painkillers and anti-inflammatory medication.
When a bursa becomes infected, further investigation and/or a course of antibiotics is usually necessary. In some cases, surgical removal of a bursa (bursectomy) may be recommended. This can be carried out either endoscopically (keyhole method) or with open surgery. After surgery the bursa grows back normally after two or three weeks.
Inflammation of a bursa (or a number of bursae) can be caused by repetitive movement, extreme pressure on the joint, traumatic injury to the joint, or an inflammatory condition such as rheumatoid arthritis.
Bursitis is more common in patients who regularly engage in physical activities involving repetitive movement. For example, running or jogging can cause bursitis in the ankle. Those with occupations that involve a lot of kneeling (such as carpet fitters) are more susceptible to bursitis in the knee joint.
Bursitis can also, less commonly, develop as a result of an infection. It can also occur as a complication of other conditions such as rheumatoid arthritis or gout.
Bursitis usually causes pain, tenderness and inflammation around the affected joint.
Depending on the severity of your condition, bursitis can cause stiffness and swelling, and the joint may be warm to the touch and the skin red. The most commonly affected joints are the knee (known as housemaid's knee), elbow, shoulder, hip, ankle, foot and Achilles tendon.
Any pain will be experienced as a dull ache, made worse by movement or pressure. Depending where the bursitis is, it may be difficult to walk, sleep on the affected side, support your weight or move your arms.
Septic bursitis, caused by an infection of a bursa, may cause additional symptoms such as a fever, an infection of the deeper layers of skin or broken skin over the affected joint.
Symptoms can include:
Your doctor will usually be able to diagnose bursitis after discussing your symptoms and physically examining the affected area.
In some cases, particularly if you have a fever, you may be recommended to have a sample of fluid taken from the inflamed bursa, which may indicate the presence of an infection (septic bursitis). You may also be asked to have a blood test to check for rheumatoid arthritis. Sometimes a magnetic resonance imaging (MRI scan) will be suggested to check for any damage to tissue.
Blood tests are a commonly used diagnostic tool to assess your general state of health, or to check for something more specific.
The symptoms of bursitis can usually be treated using painkillers and self-care techniques such as rest and avoiding movement which aggravates the condition. However, in some cases, additional specialist intervention may be required to treat the condition.
If you are suffering with a suspected condition, you should seek the advice of your doctor who will be able to refer you to Benenden Hospital for diagnosis and treatment.