Bursitis – information and doctors

Leading Medicine Guide Editors
Leading Medicine Guide Editors

Trying out a new sport or doing manual work – and suddenly a joint hurts. This is often caused by a painful but usually harmless bursitis.

It is noticeable by swelling of the affected area as well as pain, redness and warming. Inflammation of the bursa is usually caused by injuries or overstraining and as a result of diseases such as gout. If recognised and treated correctly, the symptoms can be improved quickly.

Find out here which type of doctor treats bursitis and everything you need to know about the treatment and prevention of bursitis!

ICD codes for this diseases: M70, M71, M71.9

Recommended specialists for bursitis

Brief overview:

  • Anatomy: Bursa sacs are small fluid-filled sacs that act as a buffer between bones, tendons and skin. The body has around 160 bursae.
  • What is bursitis? A painful inflammatory swelling of a bursa.
  • Causes: Excessive pressure, pressure irritation on the bursa due to repetitive or prolonged activities (such as tiling, long-distance running, etc.), injuries, bacteria, arthrosis, gout and other risk factors can cause the disease.
  • Symptoms: Redness, swelling, hyperthermia of the area of the affected bursa, pain in the joint, swollen lymph nodes as well as fever, tiredness, fatigue and general malaise.
  • Diagnosis: After the patient interview and physical examination, X-ray and blood tests lead to a definite diagnosis.
  • Treatment: After cooling and immobilising the area, anti-inflammatory and pain-relieving agents help. Fluid can be removed via cannulation (puncture). If bacterial bursitis is present, minor surgery and antibiotics are necessary.
  • Prognosis: The healing time depends on the cause. Uncomplicated bursitis takes four to six weeks to heal.
  • Prevention: The best prevention is sufficient, non-strenuous exercise and a healthy body weight. Ginger and turmeric have an anti-inflammatory effect.

Article overview

What are bursae and why do they become inflamed?

Bursae (bursa synovialis) are small sacs that are filled with fluid. They occur wherever there is increased mechanical stress in the body. They are designed to absorb pressure, reduce friction and thus protect tendons, muscles, bones and skin. If these mechanical stresses get out of hand, inflammation occurs. 

Gelenkschmerzen bei Schleimbeutelentzündung
Bursae can become inflamed in all joints of the body.

Around 160 bursae are responsible for painless movement in the body. For example, bursae are found in the shoulder joint, at the hip or in the ankle joint of the foot. Theoretically, all bursae in the body can become inflamed. However, bursitis is particularly common in stressed areas or joints, such as the shoulder, arm and shoulder, the hip, the elbow, the foot and heel or the knee. Bursitis (ICD code: M71.9) is also known as bursopathy, unspecified and can have various causes.

Schleimbeutel Hüftgelenk
Bursae protect the tissues of the hip. © bilderzwerg / Fotolia

What are the causes of bursitis?

In many cases, too much pressure is responsible for the inflammation of the bursa. In particular, recurring and/or persistent activities that exert a pressure stimulus on the bursa can cause inflammation. These activities include, for example, tiling or carpeting, sitting on hard chairs for long periods of time, or endurance sports such as long-distance running. The pressure stimulation causes so-called microtraumatisation. These tiny injuries cause an inflammatory reaction in the affected structure.

Likewise, major injuries and trauma for example owing to accidents, can also favour the development of bursitis. In the case of an open injury, bacteria can get into the wound and infect the bursa. This bacterial bursitis, however, occurs rather more rarely. More often, bursitis is the result of a blow or a collision. The bursa fills with blood as a result of the accident and then becomes inflamed.

Schleimbeutelentzündung Knie
Bursitis in the knee joint: the swelling causes pain. © Henrie / Fotolia

Pathological changes in the joints also irritate the bursa and thus promote inflammation. Diseases such as arthrosis or arthritis as well as the metabolic disease gout are therefore more frequently associated with bursitis.

What are the symptoms of bursitis?

Redness, swelling and overheating of the area around the bursa are typical signs of inflammation and leading symptoms of bursitis. Since it is mainly the bursae near the joint that become inflamed, patients experience pain in the joint. The joints are sensitive to pressure and the pain worsens with movement.

If the inflammation spreads beyond the bursa, the surrounding tissue structures and the regional lymph nodes can also swell. Other signs of pronounced and/or bacterial bursitis are:

  • Fever,
  • Fatigue,
  • Lethargy and
  • general malaise.

How is bursitis diagnosed?

In a detailed anamnesis interview, the doctor asks about the specific symptoms. The type of pain as well as physical activities, occupational activity, pre-existing conditions or accidents are of interest as possible triggers of the inflammation.

After taking the symptoms and medical history, the doctor performs a physical examination. The doctor pays attention to

  • Pain-sensitive areas,
  • Swelling,
  • Redness, and
  • Overheating.

To assess the extent of the inflammation, he also palpates the lymph nodes.

If the causes of the inflammation remain unclear or if bursitis occurs several times for no apparent reason, further examinations can be carried out. Altered joint and bone structures become visible in an X-ray examination. A blood test also helps to identify general diseases such as gout.

How do you treat bursitis?

Primary care: Calm and cold

To avoid further irritation of the inflamed bursa, the affected part of the body is temporarily immobilised. However, to avoid functional or movement restrictions, joints should not be immobilised for too long.

Cooling ointments, ice packs or cooling pads can relieve the inflammation and ensure that the swelling goes down. Anti-inflammatory and pain-relieving medicines such as ibuprofen can also counteract the symptoms.

Cannulation to remove the accumulation of fluid

Although a simple bursitis can usually be treated well, fluid accumulation can remain. This is shown in the form of a painless swelling. The doctor removes the fluid with a cannula during cannulation (puncture) and then injects anti-inflammatory cortisone into the bursa. A temporary pressure dressing is applied to prevent re-accumulation of fluid.

Bacterial bursitis: Surgery and antibiotics

Bacterial bursitis requires special treatment. The doctor must surgically open the bursa to remove the purulent fluid in the sac. In addition, patients with a bacterial infection usually have to take antibiotics. In rare cases, complete surgical removal of the bursa may be necessary.

If the bursitis is caused by another disease, such as arthrosis or gout, the treatment depends on the underlying disease. The risk of a recurrence of bursitis can be reduced only if the cause of the underlying disease is treated.

How long does it take to heal from bursitis?

The progression and duration of bursitis depend on the cause, severity and treatment of the disease. An uncomplicated bursitis heals without consequences within four to six weeks if treated adequately.

Consistent rest, taking anti-inflammatory medication and regular cooling and massages can have a positive influence on the healing process and reduce the duration of the disease.

Protection for bursa and joints: Nutrition and exercise in balance

You can also do good things for your joints and healthy bursae in everyday life. Make sure you take regular exercise that is adapted to your state of health and does not overburden you. At the beginning, let yourself be guided by special sports or fitness training to prevent incorrect loading. The bursae and joints also benefit from a healthy body weight in the normal range.
Turmeric and ginger are considered anti-inflammatory foods. Whether fresh or dried, these spices not only enrich your diet, but also have a positive effect on inflammation in the body.

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