Have you ever woken up with a mysterious egg-shaped swelling on your elbow or knee and have no clue what caused it? There is a good chance you have bursitis.
"Bursitis is definitely more common as you get older and just comes with the territory of living a longer and more active life," says Dr. Robert Shmerling, senior faculty editor at Harvard Health Publishing and Corresponding Member of the Faculty of Medicine at Harvard Medical School.
Bursitis or arthritis?
Bursitis also may be mistaken for arthritis because it occurs near a joint. You can often tell the difference by the particular location of the pain or swelling and by moving the joint. If it hurts with pressure but the joint moves well, it's probably not arthritis.
A look at the bursa
When it affects the elbow, the front of the knee, or the heel, the inflamed area may become painful or tender to touch, warm, and reddish. It's typical for it to swell up to resemble a goose egg or small balloon. But in the shoulder or hip, the painful area usually appears normal.
People get bursitis from an injury or overuse of a joint, like excessive kneeling when gardening or doing house projects or leaning on your elbows against a hard surface for long periods. Even doing repetitive movements like painting a ceiling, exercising with improper form, and walking with poor mechanics can increase your risk.
With bursitis, the joint's range of motion may be normal, but you feel pain during specific movements; for example, if you have hip bursitis, pain can occur from lying on your side when sleeping, walking up and down stairs, or standing from a seated position. Knee bursitis may hurt whenever the joint is fully flexed.
"Because the pain and inflammation don't always occur right after a particular activity or injury, bursitis often feels like it comes out of the blue, and you may not associate it with a specific cause," says Dr. Shmerling.
Self-care is the best way to begin treating most cases of bursitis. For example:
- Rest the area as much as possible for several days.
- Apply ice packs to the painful area for 20 minutes three or four times a day.
- Wear compressive sleeves or wrapping around the painful area.
- Use over-the-counter topical pain relievers. Look for products that contain lidocaine, salicylates, or diclofenac.
- Take a common over-the-counter nonsteroidal anti-inflammatory drug, such as ibuprofen (Advil) or naproxen (Aleve), or acetaminophen (Tylenol) to help with pain. But make sure not to exceed the proper daily dosage.
When to seek help
It often takes a week or longer for the pain and inflammation to subside, so you have to be patient and diligent with your self-care.
"See your doctor if the pain does not improve, as it might be a sign that there is something other than bursitis going on," says Dr. Shmerling.
If there is obvious swelling, have it checked out by your doctor to rule out an infection that would require antibiotics. Rarely, surgery is needed when an infection persists or recurs despite treatment.
If there is no infection and the problem persists, your doctor may use corticosteroid injections into the area around the painful bursa to speed up the healing.
You can protect yourself from repeated flare-ups by being mindful about overstressing your joints. Wear knee pads when you have to kneel for any length of time. Take regular breaks when doing repetitive work.
If you suffer from knee or shoulder bursitis, do regular stretching exercises. (See a physical therapist to learn the best and safest movements for your specific condition.) Also, losing excess weight can help reduce stress on the hip and knee that can lead to bursitis.