Bursitis?

What Is Bursitis?

Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

What Causes Bursitis?

Bursitis is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age they are able to tolerate stress less, are less elastic, and are easier to tear.

Overuse or injury to the joint at work or play can also increase a person's risk of bursitis. Examples of high-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. Incorrect posture at work or home and poor stretching or conditioning before exercise can also lead to bursitis.

 

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An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) can put added stress on a bursa sac, causing bursitis. Stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions may also increase a person's risk. In addition, an infection can occasionally lead to inflammation of a bursa.

Who Usually Gets Bursitis?

Bursitis is more common in adults, especially in those over 40 years of age.

What Parts of the Body Does Bursitis Affect?

• Elbow
• Shoulder
• Hip
• Knee
• Achilles tendon

What Are the Symptoms of Bursitis?

The most common symptom of bursitis is pain. The pain may build up gradually or be sudden and severe, especially if calcium deposits are present. Severe loss of motion in the shoulder -- called "adhesive capsulitis" or frozen shoulder -- can also result from the immobility and pain associated with shoulder bursitis.

How Can I Prevent Bursitis?

If you are planning to start exercising, you will be less likely to get bursitis if you gradually build up force and repetitions. Stop what you are doing if unusual pain occurs.

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How Is Bursitis Treated?

Bursitis can be treated in a number of ways, including:

• Avoiding activities that aggravate the problem
• Resting the injured area
• Icing the area the day of the injury
• Taking over-the-counter anti-inflammatory medicines

If the condition does not improve in a week, see your doctor.
Your doctor can also prescribe drugs to reduce the inflammation. Corticosteroids, also known simply as "steroids," are often used because they work quickly to decrease the inflammation and pain. Steroids can be injected directly at the site of injury. Injections are often, but not always, effective and can be repeated . However, multiple injections in a several month period are usually avoided due to potential side effects from the injections and the possibility of masking problems that need to be treated differently.

Physical therapy is another treatment option that is often used. This includes range-of-motion exercises and splinting (thumb, forearm, or bands).

Surgery, although rarely needed, may be an option when bursitis does not respond to the other treatment options.

Warning

Consult your doctor if you have:

• Fever (over 102 Fahrenheit) -- infection is a possibility
• Swelling, redness, and warmth
• General illness or multiple sites of pain
• Inability to move the affected area

These could be signs of another problem that needs more immediate attention.

 

What is hip bursitis?



There are two major bursae of the hip, the trochanteric bursa and the ischial bursa. These are located adjacent to the edges of the femur (thighbone) and pelvic bone, respectively. Inflammation of either can be associated with stiffness and pain around the hip joint. The trochanteric bursa is located on the side of the hip. It is separated significantly from the actual hip joint by tissue and bone. Bursitis is not arthritis and, therefore, is not a cause of true joint pain.

What is bursitis?

A bursa is a closed fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. "Bursae" is the plural form of "bursa." The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees. When a bursa becomes inflamed, the condition is known as "bursitis."

Cortisone Injection Treatment for Hip Bursitis

For what conditions are cortisone injections used?
Cortisone injections can be used to treat the inflammation of small areas of the body (local injections), or they can be used to treat inflammation that is widespread throughout the body (systemic injections). Examples of conditions for which local cortisone injections are used include inflammation of a bursa (bursitis of the hip, knee, elbow, or shoulder), a tendon (tendonitis), and a joint (arthritis).

Corticosteroid (cortisone) injection of joints and soft tissue facts

• Corticosteroids are powerful anti-inflammatory medications.
• Cortisone injections can offer fast-acting relief of inflamed muscles, joints, tendons, and bursa.
• Complications are rare but may include infection and bleeding.
• When administered by an expert, cortisone injections offer significant pain relief from inflammation with only minimal discomfort.

What are corticosteroids?       

Corticosteroids are a class of medications that are related to cortisone, a steroid. Medications of this class powerfully reduce inflammation. They are used to reduce the inflammation caused by a variety of diseases. Cortisone is one type of corticosteroid. For the purpose of this review, "cortisone" is used interchangeably with "corticosteroid."

Corticosteroids can be taken by mouth, inhaled, applied to the skin, given intravenously (into a vein), or injected into the tissues of the body. Examples of corticosteroids include prednisone and prednisolone (given by mouth), methylprednisolone sodium succinate injection (Solu-Medrol) (given intravenously), as well as triamcinolone (Kenalog), betamethasone (Celestone), methylprednisolone (Depo-Medrol), and others (given by injection into body tissues). This article describes the role of cortisone injections into the soft tissues and joints.

Cortisone Injection Side Effects

Both localized atrophy of the subcutaneous tissues and discoloration are well known side effects of cortisone injections. Sometimes these are the desired effects of the injection, as when we inject steroids around nerve entrapments, with the intent that the atrophy will decrease the pressure on the nerve.

How many cortisone injections can someone receive?

There is no absolute maximum number of cortisone injections that a person may receive. The risk of side effects increases as the number of injections increases, and so the risks and benefits of each injection are considered carefully prior to administration. It is unusual to give cortisone shots in the same location on a routine basis.

Are cortisone injections painful?

In an expert's hands, the opposite is more often the case. That is, minimal pain from the procedure is noted while relief from the pain of the inflammation occurs rapidly. Occasionally, cortisone injections of joints that have degenerated (become damaged) or that are particularly small (such as finger joints) can be associated with temporary minor pain at the time of the injection. This is not generally expected. Less frequently, nerves can be irritated, either directly by the needle during the injection or by the corticosteroid medication. Again, pain after the injection is not common or anticipated.

How long does a cortisone injection last?

At times the relief from a cortisone injection begins almost immediately after the procedure, but it can take a week for relief. A cortisone injection administered for certain conditions may be curative (such as for certain types of bursitis or mild trigger finger), but with some conditions the symptoms of the condition recur after weeks or months. In this situation, another cortisone injection can be given, but risks of side effects increase with more frequent or regular injections.

How often can someone receive cortisone injections?

How often cortisone injections are given varies based on the reason for the injection. This is determined on a case-by-case basis by the health care practitioner. If a single cortisone injection is curative, then further injections are unnecessary. Sometimes, a series of injections might be necessary; for example, cortisone injections for a trigger finger may be given every three weeks, to a maximum of three times in one affected finger. In other instances, such as knee osteoarthritis, a second cortisone injection may be given approximately three months after the first injection, but the injections are not generally continued on a regular basis.