Bursitis is painful inflammation of a bursa - a flat sac containing joint (synovial) fluid that reduces friction in areas where skin, muscles, tendons, and ligaments rub over bones). A bursa normally contains very little fluid. If injured or overused, however, the bursa may become inflamed and fill with fluid. These small, fluid-filled sacs lubricate and cushion pressure points between your bones and the tendons and muscles near your joints. They help your joints move with ease. Bursitis occurs when one of the bursae becomes inflamed. When inflammation occurs, movement or pressure is painful.

Bursitis often affects the areas around the joints in your shoulders, elbows or hips. But you can also have bursitis by your knee, heel and even in the base of your big toe. Bursitis pain usually goes away within a week or so with proper treatment, but recurrent flare-ups are common and can be frustrating.

When to seek medical advice

Usually bursitis responds well to home treatment. However, consult your doctor if:

• Bursitis pain is disabling or doesn't subside after 10 days of home treatment

• You notice excessive swelling, redness, bruising or a rash in the affected area

• Pain is sharp or shooting, especially when you exercise or exert yourself

• You have a fever

• You have other medical conditions that may increase your risk of an infection, such as diabetes, rheumatoid arthritis or an autoimmune disease, such as lupus

• You take medications that increase your risk of infection, such as corticosteroids or immunosuppressant's

Your doctor may have you undergo a physical examination and ask about your recent activities. By feeling the painful joint and surrounding area, your doctor may be able to identify a specific area of tenderness.

If it appears that something else may be causing the discomfort, your physician may request an X-ray of the affected area. If bursitis is the cause, X-ray images can't establish the diagnosis, but they can help to exclude other causes of your discomfort.

Although you usually can trace bursitis to events of overuse or pressure, there may be no obvious cause. In the latter case, your doctor may want to perform additional screening or tests to rule out other causes of joint inflammation and pain. These may include blood tests or an analysis of fluid from the inflamed bursa.

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