Bursitis occurs when the small fluid sac under the skin, known as the bursa, becomes inflamed between the joints, bones and tendons. Bursa cushions the bones, muscles and joints as they rub against each other during movement and also produce a lubricating liquid which helps to reduce friction in the body.
The cause of bursitis is usually a result of injury or repetitive movement, but it can be due to an infection, obesity or as a complication of gout or arthritis. Any bursa can become inflamed but the most common swellings occur in the shoulder, the elbow, the ankle, the knee (often nicknamed housemaid’s knee), the buttocks, the hip and the thigh. The risk of bursitis increases if you regularly do an activity repetitively. For instance, gardeners and carpet fitters can develop housemaid’s knee as a result of constant kneeling.
The symptoms of bursitis are usually quite mild and the condition often goes away on its own within a couple of weeks, but it has been suggested that 1 in every 200 visits to the GP is because of bursitis. When bursitis occurs the affected area normally feels warm to touch, appears swollen or be painful when moved. If a fever is a symptom in addition to the swelling, then it is important to see a doctor as this is usually a sign of an infection.
Treatment normally only requires a self-care approach known as PRICEM. This stands for protection (e.g. padding), rest, ice, compression (e.g. a bandage), elevation and medication (ibuprofen is recommended). If the case of bursitis is particularly severe then steroids or antibiotics can be prescribed. A doctor could also aspirate the bursa by inserting a needle into the affected area to draw out the excess fluid. Severe chronic bursitis can sometimes require surgery to remove the bursa but this is usually only as a last resort.
Bursitis can easily be prevented by protecting joints like using a knee pad, taking regular breaks from repetitive actions, warming up before exercise and strengthening the muscles using physiotherapy to give extra protection.
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