Bursitis is an inflammation of a bursa, a small structure inside every joint that helps to lubricate and cushion it. Usually bursitis occurs in the larger joints, such as the shoulder, hip, knee, or elbow. It can happen once or can recur over time. Without seeing your healthcare provider, you usually can't easily tell the difference between bursitis and pain caused by a strain or arthritis.
Bursae (one is a bursa) are fluid-filled sacs that cushion areas of friction between tendon and bone or skin. Like air-filled bubble wrap, these sacs reduce friction between moving parts of the body, such as in the shoulder, elbow, hip, knee, and heel.
The number varies, but most people have about 160 bursae throughout the body. Bursae are lined with special cells called synovial cells, which secrete a fluid rich in collagen and proteins. This synovial fluid acts as a lubricant when parts of the body move. When this fluid becomes infected by bacteria or irritated because of too much movement, the painful condition known as bursitis results.
If you have bursitis, you may notice:
- A dull ache or stiffness in the area around your elbow, hip, knee, shoulder, big toe or other joints
- A worsening of pain with movement or pressure
- An area that feels swollen or warm to the touch
- Occasional skin redness in the area of the inflamed bursa
Bursitis of the hip doesn't cause any visible swelling or skin redness because the bursae are located beneath some of your body's bulkiest muscles. In this type of bursitis, pain is primarily over the greater trochanter, a portion of your thighbone (femur) that juts out just below where the bone joins the hip.
Common causes of bursitis are overuse, stress and direct trauma to a joint, such as with repeated bumping or prolonged pressure from kneeling. Bursitis may also result from an infection, arthritis or gout. Many times, the cause is unknown. Bursitis in certain locations of your body is caused by repetitive motion related to certain activities:
- Shoulder. Bursitis of the shoulder often results from injury to the rotator cuff, the muscles and tendons that connect your upper arm bone to your shoulder blade. Causes of the injury may include falling, lifting and repetitive overhead arm activities. Sometimes it's hard to distinguish between the pain caused by bursitis and that caused by a rotator cuff injury.
- Elbow. This type of bursitis is associated with actions requiring you to repeatedly bend and extend your elbow. You may get such an inflammation by pushing a vacuum cleaner back and forth. Throwing a baseball and swinging a tennis racket or a golf club are other examples of repeated physical activities that may lead to bursitis or tendinitis of the elbow or shoulder. Simple repeated leaning on your elbows could lead to bursitis over the tip of your elbow.
- Buttocks. This type of bursitis describes an inflamed bursa over the bone in your buttocks. It may result from sitting on a hard surface for long periods, such as on a bike.
- Hip. Bursitis of the hip is frequently associated with arthritis or a hip injury. The pressure from standing or sitting for a prolonged time also may lead to bursitis of the hip.
- Knee. In this form of bursitis, a soft, egg-shaped bump occurs on the front of your knee, the result of repetitive kneeling while installing tiles, scrubbing a floor, gardening or doing other activities that place pressure on your knees. A sharp blow to the knee can cause inflammation of the bursae around the kneecap. People with arthritis who are overweight often develop bursitis of the knee.
- Ankle. Inflammation of the bursa in the ankle commonly occurs as a result of improper footwear or prolonged walking or in sports, such as ice-skating.
You may not be able to pinpoint a specific incident or activity that led to your bursitis. In some cases, the inflammation may stem from a staphylococcal infection.
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