Bursa

Bursitis

A bursa is a small fluid filled sac which protects pressure points between bones, muscles and tendons. They occur naturally (there are over 150 throughout the body) and help the joints and tendons to move easily.

However, they can become inflamed resulting in bursitis.

What causes bursitis?

Generally, increased activity or pressure can cause bursitis although they can also form over prominent joints which have become deformed due to an increase in pressure / friction (see related conditions).

Medical conditions such as rheumatoid arthritis can also cause bursitis and bursae can become infected.

What are the common symptoms?

• Pain and stiffness
• Redness around the joint
• Swelling around the joint
• Difficulty in shoes
• Difficulty in walking
• Associated deformity
• Overlying corn, sinus, discharge

How is it recognised?

Clinical examination and a detailed history allow diagnosis. X-rays help to evaluate the extent of any bony deformity and more specialised scans can help to identify the extent of bursitis.

What can I do to reduce the pain?

There are several things that you can do to try and relieve your symptoms:

• Anti-inflammatory tablets (e.g. nurofen) can help although should not be taken for long periods without professional advice
• Hot or cold ice packs can help symptoms
• Rest the foot
• Perform stretching exercises to improve joint motion
• Wear good fitting shoes
• Avoid high heels
• Wear a protective pad
• See a podiatrist

What will a podiatrist do?

If simple measures do not reduce your symptoms, there are other options:

• Advise appropriate shoes
• Consider prescribing orthotics
• Request appropriate investigations
• Drain the bursa and advise taping / strapping
• Administer a cortisone injection to reduce inflammation if indicated
• Refer for a medical opinion if indicated
• Advise on surgery

Will this cure the problem?

The conservative treatments may be sufficient to resolve symptoms and prevent recurrence. However, if the bursitis becomes chronic surgery may be necessary.

Surgery may involve simply excising the bursa but may also need to address any related deformity. See related conditions for treatment.