February 8, 2018


Fluid-filled pad

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A bursa is a small fluid-filled pad that acts as a cushion among your bones and the tendons and muscles near your joints. These pads are found throughout the body and when one of them becomes swollen or inflamed, the condition known as bursitis occurs. Occurring most often in the shoulder, elbow and hip, bursitis can also affect the knee, heel and the base of the big toe, or basically near any joint that performs frequent repetitive motion. The inflammation may result from arthritis in the joint or injury or infection of a bursa. Bursitis produces pain and tenderness and may limit the movement of nearby joints. Doing the same kind of movements every day or putting stress on your joints can put you at risk for this condition. Athletes and musicians typically suffer from bursitis at some point in their careers. The condition can be acute, which means it can occur suddenly, or chronic, meaning it persists over a long period of time.

Any kind of trauma

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Bursae, the fluid-filled pads near joints, assist movement and reduce friction between moving parts of the body. Chronic overuse of these joints can lead to bursitis, a condition that causes pain, stiffness, aching, swelling and warmth at the joint area. Any kind of trauma can also cause bursitis, which can also be caused by gout or diabetes. Because bursae at the knee and elbow lie just below the skin, they are at increased risk for puncture injuries that can lead to a form of infection known as septic bursitis. Leaning on your elbows for long periods of time and prolonged sitting, particularly on hard surfaces, can also cause the condition, which becomes more common the older you get. Bursitis pain can last for one to two weeks or longer, and typically occurs when you exercise or exert yourself. Often accompanied by a rash or a fever, bursitis may respond well to treatment or it may develop into a chronic condition if the underlying cause is not corrected.

Rule out other conditions

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If you have a sharp pain that occurs when getting out of a chair or bed, you may have bursitis of the hip. It can be caused by repeated stress on the hip area, an injury or uneven length of the legs. Certain tests such as X-rays and magnetic resonance imaging, or MRI, may be necessary to rule out other conditions that can cause similar symptoms. Treating this illness usually involves resting the joint as much as possible as well the use of nonsteroidal anti-inflammatory drugs like ibuprofen or naproxen to reduce the pain and swelling. Physical therapy may be prescribed to increase functionality and prevent muscle atrophy. If these treatments fail to produce the necessary results, it may become necessary to have fluid removed from the bursa area or to have steroid shots to reduce the pain and swelling. Surgery is rarely needed and typically only done as a last resort, with a surgeon removing the affected bursa from the hip.

Removing the fluid

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The skin on the back of the elbow is very loose, which means that a small amount of swelling may go unnoticed at first. Pain and swelling caused by bursitis often worsens with direct pressure on the elbow or by bending it. Redness or warmth at the elbow may be a sign of infection, which can be dangerous if it spreads to other parts of the arm or the bloodstream. Occasionally, an infected bursa can burst open and begin to drain pus. Removing the fluid with a hypodermic needle can be performed in an outpatient procedure, reducing the symptoms and giving the physician a sample to determine if the bursa is infected. If it is infected, an antibiotic will be prescribed. If it is not, the physician will recommend anti-inflammatory medications to reduce the pain and swelling. Corticosteroid injections may be administered if the symptoms persist. Wearing an elbow pad may be recommended to cushion your elbow and prevent any further injuries.

Take certain steps

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While not all types of bursitis can be prevented, you can take certain steps to reduce the risk and severity of flare-ups by changing the way you perform certain tasks. You may want to consider placing a small pillow between your legs if you sleep on your side and using a dolly or cart when carrying heavy loads to avoid putting stress on your shoulders. Avoid putting pressure on your elbows by not leaning or placing your weight on your elbows when you rise from a lying position. Be sure to bend your knees when you lift. Failing to do so can put extra stress on the bursae in your hips. If you garden or perform other kinds of activity that require a lot of kneeling, consider using some form of padding to reduce the pressure on your knees. Try not to sit in one position for too long because that puts pressure on the bursae in your hips and buttocks. And try to maintain a healthy weight, as being overweight can place excessive stress on your joints.

Trusted by thousands of listeners every week, T. Glenn Pait, M.D., began offering expert advice as the host of UAMS’ “Here’s to Your Health” program in 1996. Dr. Pait began working at UAMS in 1994 and has been practicing medicine for over 20 years.