What Is Bursitis?

From your head down to your big toes, your body has lots of differently shaped and sized joints. Many have something in common near the area of the joint — a customized fluid sac that provides cushioning for movement and pressure. These small cushions are known as bursae (a single one is called a bursa). Bursitis is the term used to describe inflammation or irritation of a bursa. Bursitis can result from a direct hit or from repetitive joint movements (like a tennis serve).
If a bursa becomes irritated, either by a direct hit or from a nearby joint repeating the same movement (like a tennis serve), then bursitis can occur. People can also get bursitis when the body has to change its balance or movement to adapt to differences; for example, if a person has one leg that's longer than the other.

Where Does Bursitis Occur?

Bursitis, especially in teens, is often likely to happen because of sports-related injuries, usually from repeated use of a particular joint or trauma from a direct hit in a contact sport. It's not only sporty types who get bursitis, though. It can sometimes be caused by other problems, such as arthritis or a bacterial infection of the bursa.
Here are some of the areas in which teens most commonly get bursitis:

• Elbow. Because the elbow is an essential part of many activities, like throwing a ball or swinging a tennis racket, elbow bursitis is one of the most common types of bursitis in teens.
• Knee. Bursitis in the knee can be the result of falling directly on the knee or any activity that requires long periods of kneeling.
• Hip. Bursitis of the hip is often associated with running injuries.
• Shoulder. Bursitis of the shoulder can be the result of something as simple as an awkward fall or as complicated as a rotator cuff injury (the rotator cuff keeps the shoulder secure).
• Ankle. Someone who goes overboard jumping, running, or walking can get ankle bursitis. Just wearing the wrong type of shoes for a particular activity can lead to ankle bursitis.

How to Detect Bursitis

Bursitis can cause a number of different symptoms:

• Pain and sensitivity in or around a joint. This is the most common and obvious sign that a person may have bursitis.
• Difficulty moving the affected joint. This happens because the bursa has swollen and made it tough to move the joint properly.
• Reddening of the skin. The inflamed bursa may cause the skin around the joint to change color.
• Burning. The irritated bursa can cause the skin to sting and feel warmer than usual.

If you have bursitis, the affected joint may:

• Feel achy or stiff
• Hurt more when you move it or press on it
• Look swollen and red

When to see a doctor
Consult your doctor if you have:

• Disabling joint pain
• Pain for more than two weeks
• Excessive swelling, redness, bruising or a rash in the affected area
• Sharp or shooting pain, especially when you exercise or exert yourself
• A fever

The most common causes of bursitis are repetitive motions or positions that irritate the bursae around a joint. Examples include:

• Throwing a baseball or lifting something over your head repeatedly
• Leaning on your elbows for long periods of time
• Extensive kneeling, for tasks such as laying carpet or scrubbing floors
• Prolonged sitting, particularly on hard surfaces

Some bursae at the knee and elbow lie just below the skin, so they are at higher risk of puncture injuries that can become infected and cause septic bursitis.

Diagnosed

How is bursitis diagnosed?

Bursitis is typically identified by localized pain or swelling, tenderness, and pain with motion of the tissues in the affected area. X-ray testing can sometime detect calcifications in the bursa when bursitis has been chronic or recurrent.

Treatments and Pharmacology

Bursitis treatment is usually simple and includes:

• Resting and immobilizing the affected area
• Applying ice to reduce swelling
• Taking nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others), to relieve pain and reduce inflammation

Sometimes, your doctor may recommend physical therapy or exercises to strengthen the muscles in the area. Additionally, your doctor may inject a corticosteroid drug into the bursa to relieve inflammation. This treatment generally brings rapid pain relief and, in many cases, one injection is all you'll need.
If your bursitis is caused by an infection, you'll need to take antibiotics. Sometimes the bursa must be surgically drained, but only rarely is surgical removal of the affected bursa necessary.

 Prevention

While not all types of bursitis can be prevented, you can reduce your risk and reduce the severity of flare-ups by changing the way you perform certain tasks. Examples include:

• Use kneeling pads. Use some type of padding to reduce the pressure on your knees if your job or hobby requires a lot of kneeling.
• Cushion your knees. If you sleep on your side, you may want to place a small pillow between your thighs to help keep your top knee from pressing on your bottom knee.
• Lift properly. Bend your knees when you lift. Failing to do so puts extra stress on the bursae in your hips.
• Avoid elbow pressure. Stop leaning on your elbows. If you push up from your elbows to get out of bed, consider tying a rope to the end of your bed so that you can pull yourself up that way.
• Wheel heavy loads. Carrying heavy loads puts stress on the bursae in your shoulders. Use a dolly or a wheeled cart instead.
• Take frequent breaks. Alternate repetitive tasks with rest or other activities.
• Walk around. Try not to sit in one position for too long, especially on hard surfaces, because that puts pressure on the bursae in your hips and buttocks.

 Refrence:

1. Sheon RP. Bursitis: An overview of clinical manifestations, diagnosis and management. http://www.uptodate.com/home/index.html. Accessed July 17, 2009.
2. Koutouzis T, et al. Tendinopathy and bursitis. In: Marx JA, et al. Rosen's Emergency Medicine: Concepts and Clinical Practice. 6th ed. Philadelphia, Pa.: Mosby Elsevier: 2006. http://www.mdconsult.com/das/book/body/150230519-3/863979815/1365/357.html#4-u1.0-B0-323-02845-4..50120-7--cesec26_5866. Accessed July 17, 2009.
3. Wong AL, et al. Bursitis, tendonitis, myofascial pain and fibromyalgia. In: Rakel RE, et al. Conn's Current Therapy 2008. 60th ed. Philadelphia, Pa.: Saunders Elsevier; 2008. http://www.mdconsult.com/das/book/body/151179629-3/866218324/1621/495.html#4-u1.0-B978-1-4160-4435-2..50249-1--cesec14_3920. Accessed July 20, 2009.