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Bursitis is the painful inflammation or irritation of the bursa. The bursa is a soft, fluid-filled sac that covers and cushions the movement between the bones, tendons and muscles near the joints.
Bursitis usually occurs under the shoulder muscles, at the elbows (called epitrochlear bursitis or "tennis elbow"), the hip sockets (called trochanteric bursitis), heel bones (called retrocalcaneal bursitis) or the kneecaps (called infrapatellar bursitis or "housemaid's knee"). It can also occur in the buttocks (called ischiogluteal bursitis) or the thigh (called trochanteric bursitis).
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Bursitis can be acute (a sudden, sharp pain following an injury) or chronic (a recurrent inflammation in the same area).
When a joint is overused or when it stays under pressure or tension for extended periods of time, a nearby bursa can become inflamed. The bursa fills with excess fluid, causing pressure on the surrounding tissue and resulting in bursitis.
Most commonly, bursitis is caused by trauma, infection, and crystal deposits. Some specific factors include:
Symptoms of bursitis may include:
The diagnosis of bursitis includes a medical history and physical examination. Sometimes x-rays and blood tests are needed.
Medical history will include questions about a person's recent or ongoing activity regimen and/or joint injuries. A physical examination will include the palpation (lightly pressing) of the affected area. Localized pain, inflammation and a history of unusual strain or injury two or three days before the pain begins usually indicates bursitis. X-rays are taken to exclude bony abnormalities, arthritis or calcium deposits (a sign of calcific bursitis). Blood tests may be ordered to confirm underlying conditions, such as rheumatoid arthritis or gout.
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Treatment for bursitis includes applying the R.I.C.E therapy, protecting the area, and anti-inflammatory drugs.
The R.I.C.E. therapy includes:
It can help to protect bursae close to the skin, such as the ankles and
knees, with padding. Additionally, deep-heat therapy (diathermy) can also
relieve the discomfort and inflammation of bursitis.
Anti-inflammatory medications, such as aspirin or over-the-counter nonsteroidal drugs (NSAIDs), such as ibuprofen, naproxen, or indomethacin can often be helpful. If the cause of the bursitis is bacterial, antibiotics will be administered.
If the inflammation does not respond to the R.I.C.E. therapy and medications, surgical drainage (aspiration) of fluid from the bursa and the injection of corticosteroids into the bursa is an alternative treatment. Surgical removal of the bursa is a possibility for chronic bursitis.
With adherence to treatment,
bursitis usually subside in seven to 14 days. See your doctor if it does
not subside, or if there are other signs of infection such as fever or
warmth and redness and severe tenderness around the joint.
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