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.

Treatment 

Treatment for bursitis is usually simple and includes resting and immobilizing the affected area, applying ice to reduce swelling and taking nonsteroidal anti-inflammatory drugs (NSAIDs) to relieve pain and reduce inflammation. With simple self-care and home treatment, bursitis usually disappears within a week or two.

Sometimes, your doctor may recommend physical therapy or exercise to strengthen the muscles in the area. Additionally, your doctor may inject a corticosteroid drug into the bursa to relieve inflammation. This treatment generally brings immediate relief and, in many cases, one injection is all you'll need.

If NSAIDs don't relieve your pain and inflammation, or if you're concerned about possible gastrointestinal side effects from NSAIDs, your doctor may prescribe a COX-2 inhibitor such as celecoxib (Celebrex) or rofecoxib (Vioxx) to relieve both pain and inflammation. COX-2 inhibitors may have less risk of stomach upset and stomach bleeding compared with NSAIDs. People who are allergic to sulfa, aspirin or NSAIDs shouldn't take COX-2 inhibitors.

If your bursitis is caused by an infection, you'll need to take antibiotics. Sometimes the bursa must be surgically drained, but only rarely is surgical removal of the affected bursa necessary.

To help prevent bursitis or reduce the severity of flare-ups:

• Do your stretches. Warm up or stretch before physical activity.

• Strengthen your muscles. Strengthening can help protect your joints. Wait until the pain and inflammation are gone before starting to exercise a joint that has bursitis.

• Take frequent breaks from repetitive tasks. Alternate repetitive tasks with rest or other activities.

• Cushion your joint. Use cushioned chairs, foam for kneeling or elbow pads. Avoid resting your elbows on hard surfaces. Avoid shoes that don't fit properly or that have worn-down heels.

• Don't sit still for long periods. Get up and move about frequently.

• Practice good posture. For example, avoid leaning on your elbows.

If your bursitis is caused by a chronic underlying condition, such as arthritis, it may recur despite these preventive measures.

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