Bursitis isn't cause for great worry


Q: Several weeks ago I had a painful swelling of my right elbow. I was concerned that it might be an attack of arthritis like the attacks that ended up crippling my mother. My doctor told me the problem was bursitis and it would get better in about a week with just regular aspirin treatment. The pain did go away quickly, but my concerns about arthritis continue. Could you explain the difference between bursitis and arthritis? Could the bursitis damage my elbow, and will it affect other joints in the future?

A: Arthritis and bursitis are entirely different conditions. In arthritis, the joints themselves are injured as the result of an inflammation or a "wearing out" of an important part of the joint. Rheumatoid arthritis and gout, for example, are caused by an inflammation of the joints, while osteoarthritis results from the natural wear and tear on the joints as we grow older. Each of these kinds of arthritis can lead to permanent joint damage.

While bursitis may cause symptoms similar to those of arthritis, bursitis does not involve the joints at all. Bursitis is an inflammation of a bursa, one of the small, fluid-filled sacs that act as cushions where muscles or tendons move bones or other muscles. About 150 bursae in the body allow these movements to take place with minimal friction. Bursitis occurs when a bursa becomes irritated and inflamed due to excessive pressure, injury or, most often, excessive repetitive motions. The most common sites for bursitis are the shoulders, elbows, hips, knees and feet. Housemaid's knee from scrubbing on hands and knees and bunions from tight-fitting shoes are examples of bursitis.

Bursitis almost always clears up without any specific treatment within a few weeks, although it can recur in the same place unless the underlying cause is corrected. Bursitis of the elbow is often due to leaning the elbow on a hard table while reading or writing.

The good news is that bursitis does not affect or damage the joints, so you needn't worry that the bursitis will necessarily occur at other sites, or that it will cripple you.

Dr. Margolis is professor of medicine and biological chemistry at the Johns Hopkins School of Medicine.

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