Bursitis

Diagnosis

Doctors can often diagnose bursitis based on a medical history and physical exam. Testing, if needed, might include:

• Imaging tests. X-ray images can't positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. Ultrasound or MRI might be used if your bursitis can't easily be diagnosed by a physical exam alone.
• Lab tests. Your doctor might order blood tests or an analysis of fluid from the inflamed bursa to pinpoint the cause of your joint inflammation and pain.

Treatment

Shoulder injection Enlarge image

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Shoulder injection

Shoulder injection

Injection of a corticosteroid medication into your bursa can relieve the pain and inflammation of bursitis. In some cases, your doctor might use ultrasound to guide the injection into the affected bursa. The ultrasound's hand-held transducer provides a live-action display your doctor can view on a monitor during the procedure.

Bursitis generally gets better on its own. Conservative measures, such as rest, ice and taking a pain reliever, can relieve discomfort. If conservative measures don't work, you might require:

• Medication. If the inflammation in your bursa is caused by an infection, your doctor might prescribe an antibiotic.
• Therapy. Physical therapy or exercises can strengthen the muscles in the affected area to ease pain and prevent recurrence.
• Injections. A corticosteroid drug injected into the bursa can relieve pain and inflammation in your shoulder or hip. This treatment generally works quickly and, in many cases, one injection is all you need.
• Assistive device. Temporary use of a walking cane or other device will help relieve pressure on the affected area.
• Surgery. Sometimes an inflamed bursa must be surgically drained, but only rarely is surgical removal of the affected bursa necessary.

Lifestyle and home remedies

Measures you can take to relieve the pain of bursitis include:

• Rest and don't overuse the affected area.
• Apply ice to reduce swelling for the first 48 hours after symptoms occur.
• Apply dry or moist heat, such as a heating pad or taking a warm bath.
• Take an over-the-counter medication, such as ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve, others), to relieve pain and reduce inflammation. Some are available in a form you apply to the skin.
• Cushion your knees if you sleep on your side by placing a small pillow between your legs.

Preparing for your appointment

You'll likely start by seeing your family doctor, who might refer you to a doctor who specializes in joint disorders (rheumatologist).

What you can do

Make a list that includes:

• Detailed descriptions of your symptoms and when they began
• Information about your medical history and your family's
• All medications and dietary supplements you take, including doses
• Questions to ask the doctor

For bursitis, questions to ask your doctor include:

• What is the most likely cause of my symptoms?
• What are other possible causes?
• What tests will I need?
• What treatment approach do you recommend?
• I have other medical problems. How best can I manage them together?
• Will I need to limit my activities?
• Do you have brochures or other printed material I can take? What websites do you recommend?

What to expect from your doctor

During the physical exam, your doctor will press on various spots around your affected joint to try to determine whether a specific bursa is causing your pain.

Your doctor may also ask you questions, such as:

• Did your pain come on suddenly or gradually?
• What kind of work do you do?
• What are your hobbies or recreational activities?
• Does your pain occur or worsen during certain activities, such as kneeling or climbing stairs?
• Have you recently fallen or had another injury?
• What treatments have you tried?
• What effect did those treatments have?