Bursa - A padlike sac or cavity found in connecting tissue usually in the vicinity of joints. It is lined with synovial membrane and contains a small amount of fluid (synovia) that acts to reduce friction between tendon and bone, tendon and ligament, or between other structures where friction is likely to occur.

Bursitis - Inflammation of the bursa, especially those located between bony prominences and muscle or tendon.

A - Bursitis of the shoulder

B - Bursitis of the knee or 'Housemaid's Knee'

C - Bursitis on the bone of the buttocks or 'Weaver's Bottom'

D - Bursitis of the elbow or 'Miner's Elbow'

There are over 150 Bursa in the human body. They act to lubricate and cushion pressure points between bones, tendons and muscles in and around joints. Bursitis occurs when a bursa becomes inflamed, making range of motion and pressure on the area painful. Bursitis is most prominant in areas around joints, i.e. shoulders, elbows, and hips. It is also possible to develop bursitis of the knee, heel, and even the big toe.

Bursitis is refered to as a repetitive strain injury (RSI), meaning that some sort of repetitive motion or strain on the joint/tissues has caused the injury. RSI's can occur due to work or play related activities. As the illustration above depicts, many different forms of bursitis are named after a profession or trade in which you would repetitively use the affected joint. Other causes may include inflammatory arthritis (rheumatoid arthritis or gout), acute or chronic infections.

We've outlined the most commonly seen bursitis below.

Housemaid's Knee (Prepatellar Bursitis): Results from kneeling on hard surfaces i.e. laying tile, scrubbing floors, gardening. Affects the prepatellar bursa. The inflamation is seen at the front of the knee and can grow quite large without treatment. Pain is present with activity and usually subsides at night. The swelling is rapid, being tender and wram to the touch.

Pes Anserine Bursitis: Other bursa in the knee can become inflammed such as the pes anserine bursa that lies between the the medial hamstring insertion point and the tibia. Pain with this condition is seen on the inside of the knee or the centre of the shin bone, 2 - 3 inches below the knee joint.

Weaver's Bottom (Ichiogluteal Bursitis): inflamation of the ichiogluteal bursa located between the hamstring origin and the bone in the buttocks. It is caused by sitting on a hard surface, swaying back and forth or any other kind of repetitive motion while sitting. Pain will be felt when stretching the hamstrings and while sitting. There is tenderness of the ischial tuberosity (butt bone) upon palpation.

Miner's Elbow (Olecranon Bursitis): Results from a back and forth motion of the elbow such as swinging a pick, vacuuming, throwing a baseball, swinging a tennis racket or golf club. Repetitive pressure or a hard blow to the elbow will also cause this problem. A lump may be seen on the back of the elbow due to the swelling.

Subacromial Bursitis: The subacromial bursa is located underneath the aromion of the shoulder and on top of the rotator cuff. This area is very small and can't expand. Repetitive overhead movements such as swimming, painting, and construction work can agrevate the space causing the bursa and or the rotator cuff tendons to inflame. At first the shoulder begins to ache with activity and rest. It may radiate down the arm into the biceps and front of the arm. There may also be sudden pain with lifting, throwing and reaching.

Conventional treatment for bursitis may include anti-inflammatory and pain medications, as well as ice compresses and rest. Occasionally the aspiration of fluid is required, which involves removal of the bursa fluid with a needle and syringe, under a sterile environment. Many times anti-inflammatory and pain medications only tentatively relieve the symptoms, rather then cure. When not properly treated bursitis can linger for months.

Do you know if your condition has been properly diagnosed?
There are two additional strain related conditions which are often mistaken for Bursitis of the elbow. The signs and symptoms are outlined below.