Bursitis (bur-SY-tis) is a painful condition that affects the small, fluid-filled sacs — called bursae (bur-SEE) — that cushion the bones, tendons and muscles near your joints.
Bursitis occurs when bursae become inflamed. The most common locations for bursitis are in the shoulder, elbow and hip.
A bursa is a fluid-filled sac that cushions an area of friction between tissues, such as tendon and bone. Bursae reduce friction between moving parts of the body, such as around the joints of the shoulder, elbow, hip, knee, and adjacent to the Achilles tendon in the heel.
What are causes of bursitis?
- Chronic bursitis: The most common cause of chronic bursitis is minor trauma that may occur to the shoulder (subdeltoid) bursa from repetitive motion, for example, throwing a baseball. Another example is prepatellar bursitis
- (in front of the knee) from prolonged or repetitive kneeling on a hard surface to scrub a floor or lay carpet.
- Acute bursitis: A direct blow (let’s say you accidentally bang your knee into a table) can cause blood to leak into the bursa. This causes inflammation with pain as well as swelling.
What are bursitis risk factors?
What are bursitis symptoms and signs?
- knee, and
- Overhead lifting or reaching activities are uncomfortable.
- Pain is often worse at night.
- The shoulder will usually have decreased range of active motion and be tender at specific spots.
- The pain may increase if the elbow is bent because tension increases over the bursa.
- This bursa is frequently exposed to direct trauma (bumping your arm) or repeated motions from bending and extending the elbow (while painting, for example).
- Infection is common in this bursa.
- bursa inflammation in front of the kneecap (prepatellar): Swelling on the front of the kneecap can be caused by chronic trauma (as from kneeling) or an acute blow to the knee. Swelling may occur as late as seven to 10 days after a single blow to the area, usually from a fall. Prepatellar bursitis has also been called carpet-layer’s knee, housemaid’s knee, and clergyman’s knee.
- Pes anserine bursitis: The pes anserine bursa is fan shaped and lies among three of the major tendons at the inner knee.
- This type of bursitis is most often seen in people with arthritis, especially overweight middle-aged women with osteoarthritis.
- The pain of anserine bursitis is typically produced when the knee is bent and is particularly troublesome at night. People often seek comfort in bed by sleeping with a pillow between their thighs.
- The pain can radiate to the inner thigh and mid-calf and usually increases on climbing stairs and at extremes of bending and extending.
- Pes anserine bursitis also occurs as an overuse or traumatic injury among athletes, particularly long-distance runners.
- The pain occurs when sitting and walking.
- There will be tenderness over the pubic bone, which may be made worse by bending and extending the leg.
- The pain may radiate down the back of the thigh.
- Direct pressure over the area causes sharp pain.
- The person may hold the painful buttock elevated when sitting.
- The pain is worse when person is lying down and the hip is passively bent.
- The person may have difficulty standing on tiptoe on the affected side.
HipThe iliopsoas bursa is the largest in the body and lies in front of, and deep to, the hip joint. Bursitis here is usually associated with hip problems such as arthritis or injury (especially from running).
- The pain of iliopsoas bursitis radiates down the front and middle areas of the thigh to the knee and is increased when the hip is extended and rotated.
- Extension of the hip during walking causes pain so the person may limit the stride on the affected side and take a shorter step.
- There may be tenderness in the groin area.
- Sometimes a mass may be felt resembling a hernia. The person may also feel numbness or tingling if adjacent nerves are compressed by the inflamed bursa.
ThighThe trochanteric bursa, at the outer thigh over the hip, can become inflamed to cause trochanteric bursitis. Trochanteric bursitis is very common and occurs most frequently in overweight, middle-aged women.
- Trochanteric bursitis causes deep, aching hip pain along the side of the hip that may extend into the buttocks or to the side of the knee.
- Pain is aggravated by activity, local pressure, or stretching.
- Pain is often worse at night and can make it difficult to sleep on the involved side.