Bursitis. Other joints are found between the different bones of your fingers and toes. You also have joints that allow your vertebrae to move.

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Bursitis Introduction Bursitis is a common condition that causes swelling around muscles and bones. It happens most often in the shoulder, elbow, hip, or knee.

1 Bursitis Introduction Bursitis is a common condition that causes swelling around muscles and bones. It happens most often in the shoulder, elbow, hip, or knee. Bursitis is usually caused by overusing a joint or by direct injury to a joint. People who perform activities that require repetitive motions or place stress on joints are at higher risk for bursitis. This reference summary will help you understand bursitis. It explains its symptoms, causes and treatment options. Anatomy Bursae are found throughout your body. Bursitis occurs when one of your bursae becomes inflamed. The following slides review information about your bones and muscles to help you better understand how bursitis affects your body. Bones help you stand up straight and muscles help your bones move together. Bones connect at the joints. The most obvious joints are the shoulders, elbows, wrists, hips, knees and ankles. Other joints are found between the different bones of your fingers and toes. You also have joints that allow your vertebrae to move. The bones of a joint are covered on the ends by a material called cartilage. Cartilage keeps your bones from rubbing against each other during motion. 1

Between the 2 pieces of cartilage in a joint, there is a little bag lined by special tissue known as synovium. The synovium secretes fluid that helps lubricate the joint.

A bursa is a small, fluid-filled sac that acts like a cushion between a bone and other moving body parts such as muscles, tendons, or skin. They are lined with synovial membranes.

2 Between the 2 pieces of cartilage in a joint, there is a little bag lined by special tissue known as synovium. The synovium secretes fluid that helps lubricate the joint. The combination of cartilage and synovium allows for smooth, painless motion in any given joint. A bursa is a small, fluid-filled sac that acts like a cushion between a bone and other moving body parts such as muscles, tendons, or skin. They are lined with synovial membranes. Bursa Bursae are found throughout your body. Bursitis is what happens when one or more of your bursae becomes swollen. Symptoms Bursitis means inflammation of one of your bursa sacs. This inflammation happens in the soft tissue around muscles and bones. It happens most often in the shoulder, elbow, wrist, hip, knee, or ankle. A stiff, achy feeling around your joint may be a sign that you have bursitis. If the pain gets worse when you move or press on the joint, you may be experiencing symptoms of bursitis. The area around a joint with bursitis may also look red and swollen. See your healthcare provider if you also experience: Joint pain so severe that you have trouble moving Pain that lasts more than one week A rash, redness, swelling, or bruising around a joint A fever 2

Causes A main cause of bursitis is overusing a joint. You may overuse a joint by doing repetitive tasks. Direct trauma to a joint can also cause bursitis.

3 Causes A main cause of bursitis is overusing a joint. You may overuse a joint by doing repetitive tasks. Direct trauma to a joint can also cause bursitis. An example of direct trauma is slamming your knee against the ground during a fall. Bursitis usually develops in the knee or elbow. Kneeling or leaning your elbows on a hard surface for a long time can lead to bursitis. Inflammation of the bursa may also be caused by: Infection Arthritis Gout Thyroid disease Diabetes Arthritis is a disease that causes inflammation and pain in the joints. Gout is a form of arthritis caused by high levels of uric acid. It causes swollen and stiff joints. The thyroid is a gland located beneath the voice box. It helps control growth and metabolism. Diabetes is a disease in which the body does not control the amount of glucose in the blood. It also causes the kidneys to make a large amount of urine. Bursitis is also caused by old age. People perform a lot of physical activities throughout their lives. These activities require them to repeatedly use their joints. Over time, this can cause the joints to become inflamed. 3

Risk Factors Your risk of developing bursitis increases with age. As you get older, your joints become more stressed. This increases the likelihood that you will develop joint-related pain.

This includes carpenters, gardeners, musicians, and athletes. Certain medical conditions may also increase your risk of developing bursitis.

4 Risk Factors Your risk of developing bursitis increases with age. As you get older, your joints become more stressed. This increases the likelihood that you will develop joint-related pain. For this reason, age is a risk-factor for bursitis. People who regularly perform tasks that require repetitive motions have an increased risk of developing bursitis. This includes carpenters, gardeners, musicians, and athletes. Certain medical conditions may also increase your risk of developing bursitis. Arthritis, diabetes, and gout have been linked to cases of bursitis. Diagnosis Diagnosis of bursitis begins with a medical history and physical examination. A good diagnosis depends on your healthcare provider knowing: The location of the pain When it began What you were doing when it began How long the pain lasts What relieves the pain What makes the pain worse Your healthcare provider may perform a selective tissue tension test to determine which tendon is affected. Touching specific areas of the tendon allows your healthcare provider to pinpoint the area of inflammation. Your doctor may also use magnetic resonance imaging, or MRI, to confirm inflammation. MRIs detect both bone and soft tissues like muscles, tendons and their coverings, including bursae. 4

An MRI is medical imaging in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body.

5 An MRI is medical imaging in which radio waves and a powerful magnet linked to a computer are used to create detailed pictures of areas inside the body. These pictures can show the difference between normal and diseased tissue. To rule out infection, your doctor may remove and test fluid from the inflamed area. Treatment Your healthcare provider can treat the common causes of bursitis. Complicated cases may require referral to a specialist, such as an orthopaedist or rheumatologist. Treatment focuses on healing the injured bursa. The first step in treating bursitis is to reduce pain and inflammation. Reducing pain and inflammation is done with rest, compression, and elevation. Anti-inflammatory medicines such as aspirin, naproxen, or ibuprofen can also help. Compression means pressing or squeezing together. In this instance, compression refers to a bandage designed to provide pressure to a specific area. Ice may also be used in acute injuries. However, most cases of bursitis are considered chronic, and ice is not helpful. Acute means the injury was caused suddenly and has been going on for a relatively short period of time. Chronic means the injury developed slowly over time and the pain continues to return. If bursitis is the result of an acute injury and ice is needed, an ice pack can be applied to the affected area for minutes every 4 to 6 hours for 3 to 5 days. Your healthcare provider may recommend longer use of ice and a stretching program. Your doctor may advise you to limit the amount of activity involving the affected joint to encourage healing and prevent further injury. In some cases, protective devices may temporarily reduce stress to the inflamed bursa. This speeds up healing. Protective devices include foot orthoses for the ankle and foot, or splints for the knee or hand. These devices allow general activities, like walking, to continue as normal. 5

Corticosteroids that are used in the injections are man-made medicines. They resemble hormones that the body naturally produces to fight inflammation.

6 For severe cases of bursitis, you may receive a corticosteroid injection into the area surrounding the inflamed bursa. Even though corticosteroid injections are a common treatment, they must be used with caution. They may lead to weakening or rupture of a tendon. Corticosteroids that are used in the injections are man-made medicines. They resemble hormones that the body naturally produces to fight inflammation. Iontophoresis may also be used to deliver corticosteroid medication to the affected area. Iontophoresis uses an electrical current to push the medicine through the skin, directly over the inflamed bursa. Severe cases of bursitis may also be treated with therapeutic ultrasound. Therapeutic ultrasound is a type of physical therapy in which sound waves are used to massage certain tissues. It warms deep tissues and can improve blood flow. Iontophoresis If there is still no improvement after 6-12 months, your healthcare provider may perform surgery to repair damage and relieve pressure on the bursae. If the bursitis is caused by an infection, your healthcare provider may prescribe antibiotics. However, this is only an option if the infection is caused by bacteria. Antibiotics cannot treat an infection caused by a virus. Always speak to a healthcare provider before starting a medication. Prevention There are several ways to prevent inflammation or reduce the pain caused by inflammation. When engaging in physically demanding activities: Warm up or stretch before an activity Begin new activities or exercise regimens slowly Increase physical demands after completing several well-tolerated sessions 6

Talk to a physical trainer about exercises to strengthen the muscles around your affected joints When going about daily activities: Practice good posture and position your body properly Take breaks

of tools using gloves or padding Use two hands to hold heavy tools or equipment If you have a history of bursitis, talk to your healthcare provider before engaging in new exercises and activities.

7 Talk to a physical trainer about exercises to strengthen the muscles around your affected joints When going about daily activities: Practice good posture and position your body properly Take breaks from repetitive tasks often Do not sit still for long periods To reduce the pain caused by bursitis: Cushion the affected joint using knee and elbow pads that have foam Increase the gripping surface of tools using gloves or padding Use two hands to hold heavy tools or equipment If you have a history of bursitis, talk to your healthcare provider before engaging in new exercises and activities. Summary People get bursitis by overusing a joint. It can also be caused by direct trauma or injury. Your risk of developing bursitis increases with age. Regularly performing the same motions also increases the risk of developing bursitis. Warming up or stretching before beginning the activity, practicing good posture, and using two hands to hold heavy equipment are just a few ways to prevent bursitis. If you have a history of bursitis, talk to your healthcare provider before engaging in new exercises and physically-demanding activities. 7

Joint Injuries and Disorders

Joint Injuries and Disorders Introduction A joint is where two or more bones come together. Your joints include the knees, hips, elbows and shoulders. There are many types of joint disorders, including