Bursitis is the inflammation or irritation of the bursa. The bursa is a sac filled with lubricating fluid, located between tissues such as bone, muscle, tendons, and skin, that decreases rubbing, friction, and irritation.

What Causes Bursitis?

This condition is most often caused by repetitive, minor impact on the area, or from a sudden, more serious injury. Age also plays a role. As tendons age they are able to tolerate stress less, are less elastic, and are easier to tear.

Overuse or injury to the joint at work or play can also increase a person's risk. Examples of high-risk activities include gardening, raking, carpentry, shoveling, painting, scrubbing, tennis, golf, skiing, throwing, and pitching. Incorrect posture at work or home and poor stretching or conditioning before exercise can also lead to bursitis.

Shoulder

An abnormal or poorly placed bone or joint (such as length differences in your legs or arthritis in a joint) can put added stress on a bursa sac, causing bursitis. Stress or inflammation from other conditions, such as rheumatoid arthritis, gout, psoriatic arthritis, thyroid disorders, or unusual medication reactions may also increase a person's risk. In addition, an infection can occasionally lead to inflammation of a bursa.

Who Usually Gets Bursitis?

Bursitis is more common in adults, especially in those over 40 years of age.

What Parts of the Body Does Bursitis Affect?

Base of the thumb
Elbow
Shoulder
Hip
Knee
Achilles tendon

What Are the Symptoms of Bursitis?

The most common symptom is pain at the site of the bursa and beyond. The pain may be a gradual buildup or sudden and severe, especially if calcium deposits are present. Loss of motion in the shoulder -- called "adhesive capsulitis" or frozen shoulder -- can also be a sign of bursitis.

How Can I Prevent Bursitis?

Bursitis can be prevented with a gradual buildup in activities, with limited force and limited repetitions. Stop what you are doing if unusual pain occurs. Try again later and if pain recurs, do not continue the activity that day.

How Is Bursitis Treated?

Bursitis can be treated in a number of ways, including:

Avoiding activities that aggravate the problem.
Resting the injured area.
Icing the area the day of the injury.
Taking over-the-counter anti-inflammatory medicines.

If the condition does not improve in a week, see your doctor.

Your doctor can also prescribe medications to reduce the inflammation. Corticosteroids, also known as "steroids," are often used because they work quickly to decrease the inflammation and pain. Steroids are also one of the safest treatment methods and can be injected directly at the site of injury. Unfortunately, 30% of people may not get complete relief from one injection and 2% of people may even get worse. Another disadvantage is that for recurrent cases, it is not safe to administer steroids frequently (more than every three months).

Physical therapy is another treatment option that is often used, especially for a frozen shoulder. This includes range of motion exercises and splinting (thumb, forearm, or bands).

Surgery, although rarely needed, may be an option when bursitis does not respond to the other treatment options.

Warning

Consult your doctor immediately if you have:

Fever (over 100 Fahrenheit)
Swelling, redness, and warmth
General illness or multiple sites of pain
Inability to move the affected area

These could be signs of another problem that needs more immediate attention.

Reviewed by the doctors at The Cleveland Clinic Department of Rheumatic and Immunologic Diseases

WebMD Medical Reference provided in collaboration with the Cleveland Clinic

SOURCE: American College of Rheumatology.

Reviewed by Michael W. Smith, MD on

Edited by Marc C. Levesque, MD, PhD on February 01, 2007

'Portions of this page © The Cleveland Clinic 2000-2005

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Cymbalta is approved for the management of fibromyalgia.

Important Safety Information

Cymbalta^® (duloxetine HCl) is approved for the treatment of depression and generalized anxiety disorder, and for the management of diabetic peripheral neuropathic pain and fibromyalgia.

What should I talk about with my healthcare provider?

Patients on antidepressants and their families or caregivers should watch for new or worsening depression symptoms, unusual changes in behavior, thoughts of suicide, anxiety, agitation, panic attacks, difficulty sleeping, irritability, hostility, aggressiveness, impulsivity, restlessness, or extreme hyperactivity. Call your healthcare provider right away if you have thoughts of suicide or if any of these symptoms are severe or occur suddenly. Be especially observant within the first few months of antidepressant treatment or whenever there is a change in dose.

You should also know that:

Suicide is a known risk of depression and some other psychiatric disorders.
Antidepressants may increase suicidal thoughts or behaviors in some children, adolescents, and young adults especially within the first few months of treatment or when changing the dose. No increased risk has been shown for adults over age 24, and risk decreased for those over age 65.
All patients starting therapy should be monitored appropriately and observed closely for new or worsening depression symptoms, suicidal thoughts or behavior, or unusual changes in behavior.
Cymbalta^® is not approved for use in patients under age 18.

Who should NOT take Cymbalta?
You should not take Cymbalta if:

You have recently taken a type of antidepressant called a monoamine oxidase inhibitor (MAOI)
You have uncontrolled narrow-angle glaucoma (an eye disease)
You are taking Mellaril^® (thioridazine)

What other important information should I discuss with my healthcare provider?
Before starting Cymbalta, tell your healthcare provider:

about all of your medical conditions, including kidney problems, glaucoma, or diabetes
about your alcohol use
if you are taking nonprescription or prescription medicines, including those for migraine, to address a possible life threatening condition
if you are taking NSAID pain relievers, aspirin, or blood thinners. Use with Cymbalta may increase bleeding risk
if you are pregnant, plan to become pregnant during therapy, or are breastfeeding an infant

While taking Cymbalta, tell your healthcare provider:

if you have itching, right upper belly pain, dark urine, yellow skin/eyes, or unexplained flu-like symptoms, which may be signs of liver problems. Severe liver problems, sometimes fatal, have been reported
if you have high fever, confusion, and stiff muscles to address a possible life-threatening condition
before stopping Cymbalta or changing your dose
if you experience dizziness or fainting upon standing, especially when first starting Cymbalta or when increasing the dose. Your healthcare provider may periodically check your blood pressure while you are taking Cymbalta

If you have any questions, talk to your healthcare provider before taking Cymbalta.

What are the possible side effects of Cymbalta?

The most common side effect of Cymbalta was nausea. For most people who had it, the nausea was mild to moderate. Other common side effects included dry mouth, sleepiness, constipation, decreased appetite, and, increased sweating. This is not a complete list of side effects.

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