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Bursitis

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Definition

Bursitis is a condition when one or more of the bursae becomes inflamed. When inflammation occurs, movement or pressure at that joint results in pain.

Bursae are small, fluid-filled sacs that lubricate and cushion pressure points between the bones, tendons and muscles near your joints. The bursae help the joints to move comfortably and with ease.
Bursitis often affects your shoulders, elbows or hip joints. However, other joints in the body like knee, heel and the base of the big toe may be affected.

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Causes

  • Chronic overuse of a joint e.g. miner's elbow.
  • Activities requiring repetitive movement of a joint
  • Direct trauma to a joint e.g. prolonged pressure from kneeling as seen in a condition called housemaid's knee.
  • Pressure from prolonged standing e.g. bursitis of hip joint
  • Infection of the joint space e.g. staphylococcal infection, tuberculosis
  • Rheumatoid arthritis
  • Gout

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Symptoms

  • A dull ache or stiffness in the area of the affected joint.
  • Pain is worse on movement or pressure
  • The affected joint area is tender to touch
  • The area feels swollen or warm over the affected joint
  • Occasional redness of skin over the affected joint

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Implications

Recurrent flare ups of bursitis can be very frustrating and may limit mobility and independence. Prolonged and persistent inflammation can eventually result in a chronic condition. Frequent injections of steroids in the areas surrounding the affected joints may cause damage to tendons and ligaments.

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What You Can Do

  • Home Care
    • Rest
    • Immobilize the affected joint
    • Apply ice packs to reduce swelling.
    • Apply heat to relax muscles once the swelling and redness of the affected joint subsides.
    • Elevate the affected joint to help reduce swelling.
    • Use a bandage or foam pad to protect the joint from undue pressure or injuries.

  • Medications
    • Aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
    • COX-2 inhibitor such as celecoxib (Celebrex) or rofecoxib (Vioxx).
    • Antibiotics for the treatment of bacterial infection of the joint space.
    • Injection of corticosteroid medication into the bursa to relieve inflammation

  • Surgical Treatment
    • Surgical drainage or surgical removal of affected bursa.

  • Physical Therapy
    • Sometimes physical therapy may be recommended to strengthen muscles in the surrounding area of the affected joint

  • Prevention
    • Avoid activities that might subject your joints to repetitive movements.
    • Warm up or stretch before physical activity.
    • Strengthen your muscles
    • Take frequent breaks or alternate repetitive tasks with rest or other activities.
    • Use cushioned chairs, foam pads for knees and elbows.
    • Avoid resting your elbows on hard surfaces
    • Avoid wearing shoes that do not fit properly or have worn-down heels.
    • If you lead a sedentary life style, get up and move about frequently to avoid excessive pressure on the joints from prolonged periods of sitting in one place.

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Bursitis