Swelling and inflammation near a joint may be a sign of bursitis, a condition that involves buildup of liquid and inflammation in a bursa sac that cushions a joint.

This condition has earned some interesting names over the years: housemaid’s knee, student’s elbow, and tailor’s bottom, to name a few.

What Causes Bursitis?

Simply put, bursitis is the inflammation of a bursa and buildup of fluid in the bursa sac.

  • A bursa is a thin, slippery sac found around a joint that serves to reduce friction between bone and surrounding soft tissue, such as skin, muscles, ligaments and tendons.
  • A bursa sac is made up of a synovial membrane, or synovium, that produces and contains synovial fluid.

Excessive friction, a trauma, or other condition can irritate the synovium and cause it to become inflamed. The inflamed synovium will thicken and produce excess synovial fluid, and can cause symptoms such as localized swelling, skin redness and warmth, tenderness and pain.

Of the approximately 160 bursae in the body, only a handful of them usually cause bursitis. These usual suspects are found in the knee, shoulder, elbow, and hip. Less frequently, bursitis may also occur in the heel, wrist, buttocks and big toe.

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Main Bursitis Symptoms

Bursitis symptoms and diagnosis can vary slightly depending on which joint is affected. Often the inflammation and swelling of a bursa makes a visible bump that a doctor will recognize as probable bursitis. During evaluation, a doctor will consider other possible causes of the joint problem as well, such as arthritis, tendinitis, tendon or ligament damage, a fracture, or a tumor.

Bursitis is caused by overuse or excessive pressure on the joint, injury, infection, or an underlying condition, such as osteoarthritis, rheumatoid arthritis, gout, pseudogout, or ankylosing spondylitis. When bursitis is caused by an underlying condition, the condition must be treated along with the bursitis. When bursitis is caused by infection, called septic bursitis, medical treatment and antibiotics are necessary.

General Bursitis Treatment & Prevention

If not properly treated, a case of bursitis can turn into chronic bursitis, flaring up on and off for several weeks or longer. Bursitis treatment involves resting the joint, often combined with other methods to alleviate swelling, including NSAIDs (e.g. Aleve, ibuprofen), icing the joint, elevating the joint, and wrapping the joint in an elastic bandage. Cases of septic bursitis must also be treated with antibiotics to prevent the infection from spreading to other parts of the body or into the bloodstream.

A doctor may aspirate a bursa with a needle and syringe to relieve uncomfortable pressure, and may recommend corticosteroid injections for cases that don’t respond to other treatments. In very rare cases surgery may be warranted.

People can lower the risk of bursitis by gradually strengthening and stretching the muscles around the joints and taking regular breaks from repetitive motion that might irritate bursae. Prolonged time resting on the elbows or kneeling should be avoided; if it cannot be avoided, wearing cushioned elbow and knee pads can help protect the bursae. Comfortable, supportive, low-heeled shoes can help prevent bursitis in the foot.

Written by Grant Cooper, MD
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