A bursa is a small fluid-filled sac under the skin, found in any area where friction occurs.
There are over 150 bursae in the body, usually over the joints and between tendons and bones.
The term 'bursitis' is the name given to any inflammation of a bursa and it has been calculated that 1 in every 200 visits to a GP is because of bursitis.
The most common areas affected are the shoulder, knee, ankle, elbow and hip.
What are the causes?
The risk of developing bursitis is higher with activities that involve repetitive movement, such as jogging, and in people who do a lot of kneeling, such as carpet fitters and gardeners – who can develop the classic 'housemaid's knee'.
What are the symptoms?
These are typically of pain or a dull ache in the affected area, worsened on movement, tenderness, swelling and reduced movement in the affected area.
Most cases can be diagnosed on simple examination without the need for specialised tests but if a fever is present then fluid may be taken from the bursa to check for the presence of infection.
How is it treated?
Doctors use the 'PRICEM' regime. This stands for protection, rest, ice packs, compression, elevation and medication.
- Protection: this includes wearing padding – such as knee pads for example - to protect the joint from any further injuries.
- Rest: rest the area affected until symptoms improve.
- Ice; this can help reduce symptoms of swelling and pain so wrap an ice pack, or pack of frozen peas in a towel and apply the towel to the affected area for 10 minutes, repeating every few hours.
- Compression: you may find using an elastic bandage to compress or squeeze the affected joint helpful in relieving pain.
- Elevation: if you are able to, elevating the affected body part above the level of your heart can help reduce swelling and inflammation.
- Medication: painkillers, such as paracetamol or ibuprofen, are effective ways of treating pain and inflammation.
Check with your doctor first that there is no contraindication to taking these and that you're taking the correct dose.
Occasionally the swelling in a bursa is so significant that aspiration may be required.
Here, the fluid is drained out by your doctor using a needle and syringe.
Other possible treatments include corticosteroid injections directly into the affected body part or antibiotic tablets if the bursitis is caused by an infection.
If a bursitis does not get better after 8 weeks of treatments then specialist referral may be needed, such as to a rheumatologist or an orthopaedic surgeon.
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