Diagnosing the Most Common Types of Bursitis

Shoulder bursitis is a common cause of shoulder pain.  The shoulder bursa allows the rotator cuff on the top of the shoulder to glide beneath the acromion.  When the bursa is inflamed, the condition that results is called subacromial bursitis.

The words 'shoulder bursitis' and 'rotator cuff tendonitis' are often used interchangeably, and the truth is that these conditions represent a related set of problems that ultimately have the same treatment options.

When shoulder bursitis fails to improve with simple treatments, there are surgical treatment options.  The usual surgical treatment is called a subacromial decompression.  In this surgical procedure, the bursa is removed to relieve inflammation.

Hip bursitis causes pain on the outside of the hip joint. Often patients worry these are symptoms of hip arthritis, but the pain of hip bursitis is consistently felt on the outside of the hip, whereas arthritis of the hip is typically felt in the groin, thigh or buttocks. 

Hip bursitis most often hurts with direct pressure on the hip, and is often a problem when people sleep on their side at night. Hip bursitis will almost always improve with simple treatments including rest, ice, injections, and physical therapy.

Elbow bursitis, also called olecranon bursitis, occurs when there is pain and swelling of the bursa on the back of the elbow joint.  The olecranon is the bony prominence of the back of the elbow.  This is the upper part of the ulna bone, and the olecranon bursa sits just between the skin and bone. 

The olecranon bursa is the most common bursa to become infected.  Often scrapes, cuts, or even injections into the bursa, can allow a bacterial infection to occur.  While minor infections can improve with nonsurgical treatment, often an infected olecranon bursa requires surgical treatment.

Kneecap bursitis occurs when there is pain and swelling on the front of the knee joint, directly on top of the kneecap.  The medical name of the kneecap is the patella, and kneecap bursitis is often called prepatellar bursitis.

Swelling around the knee can be confusing, and prepatellar bursitis can be distinguished from other causes of knee swelling by examining the joint to determine if the swelling is in front of the knee or inside the joint.

Kneecap bursitis occurs when people spend time kneeling.  This often occurs in workers such as roofers or flooring workers.  It can also occur from activities around the house such as floor cleaning, gardening, or even playing with little kids.  One of the best ways to prevent kneecap bursitis is to wear knee pads to cushion the prepatellar bursa.

Bursitis treatment depends on the specific type of bursitis, as there are subtle differences in treatment of the different conditions.  However, there are some general themes in treatment to allow the inflamed bursa to rest, allow inflammation to subside, and prevent the condition from becoming persistent or recurrent.

Some of the most common treatments utilized to manage bursitis include ice application, oral anti-inflammatory medications, and cortisone injections. All of these treatments are aimed to control inflammation of the affected area. In addition, physical therapy can be an essential aspect of treatment. Even for physically active people, improving joint mechanics to restore normal alignment and joint function can help to alleviate the symptoms of bursitis and ensure that there will not be a recurrence of symptoms over time. Many people who are physically active neglect this aspect, thinking that physical activity is a substitute for improving joint mechanics. By doing physical therapy, and targeting specific abnormalities in joint function, inflammatory problems like bursitis can subside and stay resolved.