Bursitis is the inflammation of a bursa, a small, fluid-filled sac found throughout the body. These sacs function as cushions, reducing friction between tissues such as bones, muscles, tendons, and skin near joints. When a bursa becomes irritated, it swells and causes pain, a common musculoskeletal complaint. Whether to apply compression to an inflamed bursa is a nuanced question that depends on the specific cause and presentation of the inflammation.
Identifying Bursitis and Its Causes
Bursae are located near bony prominences (e.g., elbow, shoulder, hip, knee, heel) to facilitate smooth movement and protect underlying structures. Any of the over 150 bursae in the human body can become inflamed. The vast majority of cases arise from two primary mechanical issues: overuse or repetitive strain, and direct trauma. Repetitive motions, like those involved in certain occupations or sports, can chronically irritate the bursa, causing it to produce excess fluid and swell.
Direct impact or sustained pressure, such as kneeling for long periods or resting on an elbow, can also trigger inflammation. Symptoms typically include localized pain, noticeable swelling over the joint, and tenderness when the area is pressed. Movement involving the affected joint often aggravates the pain, as the swollen bursa is compressed by surrounding tissues. A less common but more concerning cause is infection, which results in septic bursitis.
Compression for Bursitis: Application and Limitations
Compression can be beneficial for managing bursitis because its application helps control and reduce swelling (edema). External pressure from compression garments or elastic wraps encourages the reabsorption of excess fluid back into the circulatory system. This reduction in fluid volume can alleviate discomfort and potentially accelerate the healing process for non-infected cases.
For compression to be effective and safe, it must be applied correctly using elastic bandages or specialized supports that provide snug, but not constricting, pressure. The goal is a light, supportive squeeze, not a tight tourniquet effect, which could impair circulation or increase localized pain. Studies examining nonseptic cases, such as olecranon (elbow) bursitis, suggest that compression bandaging combined with anti-inflammatory medication can offer a favorable balance of safety and effectiveness.
However, compression carries significant limitations and risks, especially if the bursa is severely distended. Applying pressure to an already swollen, fluid-filled sac can increase internal tension, resulting in worsened pain. Compression is largely contraindicated if the bursitis is suspected to be septic, meaning it is caused by a bacterial infection. Signs of septic bursitis include intense redness, warmth, fever, and pain that is out of proportion to the swelling. In the presence of infection, applying compression could potentially spread the bacteria or delay necessary medical treatment.
Other Essential Treatments for Bursa Inflammation
The management of bursitis focuses on reducing inflammation and preventing recurrence. Resting the affected area by avoiding the irritating activity or position is foundational to allowing the bursa to heal. This involves temporarily modifying physical activities or using padding to protect the area from direct pressure.
Applying a cold compress or ice pack can significantly reduce both pain and inflammation. Ice should be applied for short intervals (typically 15 minutes), several times a day, especially in the initial 24 to 48 hours. If the bursitis is in a lower limb, elevating the area above heart level leverages gravity to assist in draining excess fluid and minimizing swelling.
Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, reduce the inflammatory response and manage pain. If conservative measures fail to provide relief within a week or two, or if symptoms worsen, professional medical intervention is required.
Medical Interventions
Physicians may drain the excess fluid from the bursa in a procedure called aspiration, which also allows for testing to rule out infection. For persistent, non-infected cases, a corticosteroid injection may be administered directly into the bursa to suppress inflammation. Confirmed septic bursitis requires a course of antibiotics.