Brief Overview: Bursitis is inflammation of the bursae, the small fluid-filled sacs that cushion bones, tendons, and muscles near joints. Chronic bursitis develops when inflammation persists or recurs, leading to ongoing pain, swelling, and reduced mobility. It most commonly affects the shoulder, elbow, hip, and knee.
Prevalence: The exact prevalence is unknown.
Etiology:
- Repetitive stress (e.g., kneeling, lifting, overhead reaching).
- Degenerative joint disease/arthritis increasing joint friction.
- Injury or trauma to joint area.
- Infection (septic bursitis) – especially in elbow/knee.
- Crystal deposits (gout, pseudogout).
Risk Factors:
- Older age (degenerative changes).
- Repetitive motion occupations/hobbies (gardening, housework, sports).
- Osteoarthritis, rheumatoid arthritis, gout.
- Diabetes, obesity.
- Poor posture or muscle weakness leading to abnormal joint stress.
Commonly Associated Conditions:
- Osteoarthritis, rheumatoid arthritis
- Gout/pseudogout
- Rotator cuff disease (shoulder)
- Diabetes
- Chronic tendonitis
Common Medications:
- NSAIDs
- Oral glucocorticoids
- Intrabursal glucocorticoid injections
Common Labs, Imaging, and Tests:
- Diagnosis is often clinical (history + exam).
- X-ray: may show arthritis or bone spurs.
- Ultrasound or MRI: visualize bursitis and rule out rotator cuff tear/tendonitis.
- Aspiration of bursal fluid: if infection suspected → culture, crystal analysis (gout).
- Labs if systemic inflammation suspected: ESR, CRP, uric acid.
Common Symptoms:
- Pain
- Swelling
- Tenderness
- Stiffness
Common Treatments:
- Rest
- Joint protection – brace, splint, cushions, orthotics
- Physical therapy
- Cold compress
- Surgery (rare) may be indicated for some
Physical Findings:
- Localized tenderness over joint.
- Swelling, warmth, mild redness.
- Decreased range of motion due to pain.
- Soft, fluctuant mass may be palpable over bursa.
- Gait or posture changes if hip/knee involved.
Potential Complications and Contraindications:
- Complications:
- Chronic pain and disability
- Recurrent flares with activity
- Septic bursitis → sepsis if untreated
- Functional decline (reduced mobility)
- Contraindications:
- Frequent NSAID use: risk of GI bleeding, kidney disease, heart issues in seniors
- Steroid injections: avoid repeated frequent injections (can weaken tendons)
General Health and Lifestyle Guidance:
- Use joint protection: cushions, proper footwear, ergonomic aids as directed by your healthcare provider
- Gentle stretching and strengthening (with PT guidance)
- Warm up before activities
- Alternate rest and activity — avoid prolonged kneeling, leaning, or repetitive movements
- Apply ice/heat as tolerated for flares
- Maintain healthy weight to reduce joint stress
- Report fever, spreading redness, or sudden worsening pain (possible infection) to your healthcare provider
Suggested Questions to Ask Patients:
- Which joint is painful? When did the pain start?
- What activities make it worse? Does rest help?
- Do you have swelling, redness, or warmth over the joint?
- Do you take pain medicine? How often?
- Do you have arthritis, gout, or diabetes?
- Have you had recent fevers or infections?
- Does pain interfere with walking, sleep, or daily activities?
Suggested Talking Points:
- Bursitis is inflammation of the cushioning sac near your joint — it can become chronic if the joint is stressed repeatedly.
- Bursitis often improves with rest, gentle exercise, and simple treatments.
- Overusing pain medicine like ibuprofen can be harmful, especially in older adults. Safer options may be available.
- Physical therapy, posture adjustments, and weight control can help reduce stress on the joint.
- If you notice fever, redness, or worsening swelling, call your provider — that could mean infection. Always report any new, worsening, or persistent symptoms to your healthcare provider.
Sources:
This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner.