Bursitis

Diagnosis

The diagnosis of bursitis often requires assessment of medical history and conduct of a physical exam. A physical exam involves evaluation of symptoms and inspection of the area surrounding the damaged body part. Patients may need to tell the doctor what they were doing before they felt symptoms for the first time, as well as the profession or pastime where they need to perform repeated motions.

• Imaging tests: If the bursitis cannot be identified with a physical exam alone. X-ray images cannot definitively rule out bursitis, but they can help rule out other possible reasons of the symptoms. Swollen bursae can be detected with ultrasound or MRI.
• Lab tests: A blood test may be necessary to detect infection. If the doctors believe that the affected bursa is infected, they will need to conduct an aspiration.

Treatment

Most cases of bursitis heal on their own with rest and at-home therapies. Rest is usually all that is required to treat bursitis. Avoid the activities or positions that caused the bursa to irritate. Stopping activities that exert pressure on that region of the body will allow it to heal and prevent further damage. Conservative methods such as heat or ice, elevating the affected region, and pain relievers can help alleviate discomfort.

Other treatment options may include:

• Medication: Antibiotics may be prescribed in cases of infection. The doctor will check if the swelling is caused by an infection.
• Injections: This medication usually works rapidly. Injection of corticosteroids into the bursa is utilized to reduce inflammation and pain. In most cases, only one injection is required.
• Therapy: Physical therapy can help improve one’s range of motion. It can be used to strengthen the muscles in the affected area, relieve discomfort, and avoid recurrence. Occupational therapy may be used to teach patients how to move in ways that do not strain the area.
• Assistive technology: Wearing a splint, sling, or brace to support the injured area. Using a walking cane or other device to reduce pressure on the affected area may be recommended.
• Surgery: If various therapies are ineffective and patients have been experiencing problems for six months or more, surgery to remove the bursa may be necessary. In some cases, an inflamed bursa may need to be surgically drained.