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Bursitis

Inflammation or irritation of a bursa, the fibrous sac that acts as a cushion between moving structures of bones, muscles, tendons or skin.

PubMed Health Glossary
(Source: NIH - National Library of Medicine)

About Bursitis

Bursitis is the inflammation of the bursa, a small, fluid-filled sac that acts as a cushion between a bone and other moving parts, such as muscles, tendons, or skin.

With bursitis, the bursa becomes red and fluid increases, causing swelling and pain.

Points To Remember About Bursitis

  • Bursitis is swelling in the bursa, a small, fluid-filled sac that cushions the bones and other body parts.
  • Bursitis is typically caused by repetitive movements that hurt the bursae over time.
  • To reduce risk of bursitis, don't sit still for long periods of time, cushion your joints when kneeling or putting pressure on your elbows, and take frequent breaks from repetitive tasks.
  • Bursitis is usually treated with rest, gentle exercise, and medication, but some severe cases may require surgery....Read more about Bursitis

NIH - National Institute of Arthritis and Musculoskeletal and Skin Diseases

What works? Research summarized

Evidence reviews

Physical tests for shoulder impingement in primary care

Impingement (or pinching) of soft‐tissues in or around the shoulder is a common cause of pain and is often linked to tissue damage in and around the joint. If doctors and therapists could identify impingement and associated damage using simple, physical tests, it would help them to inform on the best treatment approach at an early stage. We were particularly interested in the primary (community) care setting, because this is where most shoulder pain is diagnosed and managed. We reviewed original research papers for evidence on the accuracy of physical tests for shoulder impingement or associated damage, in people whose symptoms and/or history suggest any of these disorders. To find the research papers, we searched the main electronic databases of medical and allied literature up to 2010. Two review authors screened assessed the quality of each research paper and extracted important information. If multiple research papers reported using the same test for the same condition, we intended to combine their results to gain a more precise estimate of the test's accuracy. We included 33 research papers. These related to studies of 4002 shoulders in 3852 patients. None of the studies exclusively looked at patients from primary care, though two recruited some of their patients from primary care. The majority of studies used arthroscopic surgery as the reference standard. There were 170 different target condition/index test combinations but only six instances where the same test was used in the same way, and for the same reason, in two studies. For this reason combining results was not appropriate. We concluded that there is insufficient evidence upon which to base selection of physical tests for shoulder impingement, and potentially related conditions, in primary care.

Corticosteroid injections for shoulder pain

The available evidence from randomized controlled trials supports the use of subacromial corticosteroid injection for rotator cuff disease, although its effect may be small and short‐lived, and it may be no better than non‐steroidal anti‐inflammatory drugs. Similarly, intra‐articular steroid injection may be of limited, short‐term benefit for adhesive capsulitis. Further trials investigating the efficacy of corticosteroid injections for shoulder pain are needed. Important issues that need clarification include whether the accuracy of needle placement, anatomical site, frequency, dose and type of corticosteroid influences efficacy.

Arthrographic distension for adhesive capsulitis (frozen shoulder)

‐ May improve pain at three weeks.

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Summaries for consumers

Bursitis: Overview

Signs of bursitis include swelling and pain – for instance, in an elbow or knee. It can arise when too much pressure is put on one of the protective fluid-filled sacs in the body known as bursae. There are various ways to treat bursitis, depending on the cause and how it develops over time.

How can bursitis be treated?

Signs of bursitis include swelling and pain – in an elbow or knee, for example. There are various ways to treat this inflammation, depending on the cause and how it develops over time. Bursitis often arises when a bursa is constantly irritated – for example during work that requires a lot of kneeling. Bursae are small, fluid-filled sacs that act as protective cushions in the body, often near to joints. Resting the affected area and using bandages and anti-inflammatory medications usually helps to make the inflammation go away. Antibiotics are used if bacteria are involved. If the symptoms don’t improve, surgery to remove the inflamed bursa is considered.

Physical tests for shoulder impingement in primary care

Impingement (or pinching) of soft‐tissues in or around the shoulder is a common cause of pain and is often linked to tissue damage in and around the joint. If doctors and therapists could identify impingement and associated damage using simple, physical tests, it would help them to inform on the best treatment approach at an early stage. We were particularly interested in the primary (community) care setting, because this is where most shoulder pain is diagnosed and managed. We reviewed original research papers for evidence on the accuracy of physical tests for shoulder impingement or associated damage, in people whose symptoms and/or history suggest any of these disorders. To find the research papers, we searched the main electronic databases of medical and allied literature up to 2010. Two review authors screened assessed the quality of each research paper and extracted important information. If multiple research papers reported using the same test for the same condition, we intended to combine their results to gain a more precise estimate of the test's accuracy. We included 33 research papers. These related to studies of 4002 shoulders in 3852 patients. None of the studies exclusively looked at patients from primary care, though two recruited some of their patients from primary care. The majority of studies used arthroscopic surgery as the reference standard. There were 170 different target condition/index test combinations but only six instances where the same test was used in the same way, and for the same reason, in two studies. For this reason combining results was not appropriate. We concluded that there is insufficient evidence upon which to base selection of physical tests for shoulder impingement, and potentially related conditions, in primary care.

See all (9)

Terms to know

Arthritis
A general term for conditions that cause inflammation (swelling) of the joints and surrounding tissues. Some forms of arthritis may occur simultaneously with osteoporosis and Paget's disease.
Bursa
A bursa is a small fluid-filled sac. It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement.
Inflammation
Redness, swelling, pain, and/or a feeling of heat in an area of the body. This is a protective reaction to injury, disease, or irritation of the tissues.
Rheumatologist
Doctors who diagnose and treat diseases of the bones, joints, muscles, and tendons, including arthritis and collagen diseases.
Sac
A bag or pouch inside a plant or animal that typically contains a fluid.
Tendinitis
Inflammation or irritation of a tendon.
Tendons
Tough, fibrous, cord-like tissue that connects muscle to bone or another structure, such as an eyeball. Tendons help the bone or structure to move.

More about Bursitis

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Also called: Inflammation of bursa

Other terms to know: See all 7
Arthritis, Bursa, Inflammation

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