Can Rheumatoid Arthritis Cause Bursitis?

Rheumatoid arthritis (RA) is an abnormal widespread inflammation associated with the malfunction of immune system. It can cause serious damage to your joints, especially if it’s poorly controlled. More flare-ups (when the symptoms worsen) you have – the higher the risk for RA complications to occur. Can this autoimmune disease also cause bursitis?

Bursitis (topic overview)

Bursitis is a painful inflammation that affects a bursa, a small fluid-filled sac in the joint. Bursa acts as a cushion between moving parts of the joint. So it is important to help protect your joints. For example, it is responsible to reduce friction between a bone and muscle, tendon or even skin.

Bursitis can affect any joints. But in general, it is more likely to affect bursa of joints that often perform repetitive motion. The most common ones include the shoulder, hip, elbow, knees, calf, and buttocks. Sometimes it may also occur in the base of big toe and heel.

Symptoms

Bursitis is typically characterized by pain, inflammation, and tenderness in areas around the affected joint. Though the inflammation primarily affects a bursa, it may also affect other areas around a joint such as muscles, ligaments, or tendons. The severity of the problem is usually dependent on how inflamed bursa is.

The pain often feels like a dull ache, and it usually hurts more with movement or pressure. For instance, if your shoulder is affected, you may find it painful (more difficult) when you lie on the affected side. The affected area around the joint may also become very stiff – also may look swollen and warm (red).

The way of how the symptoms behave varies. They may strike suddenly (acute) or last longer (chronic). Furthermore, the problem can also come back in the same body area.

Tests and diagnosis

Physical examination is required to identify the exact cause of the problem. This includes asking about your symptoms and examining the affected body area.

Since bursitis symptoms occur near a joint, they could be mistaken for arthritis. If your doctor believes that you have bursitis, some of the following tests may be required:

  1. Examining a fluid sample of the affected bursa through a procedure called aspiration. This is especially true if you have fever, which may signal an infection such as septic bursitis.
  2. If necessary, you may also be asked to have other tests such as a blood test and imaging tests. This is especially true if your doctor needs to rule out other conditions such as gout and rheumatoid arthritis.
Treatments

The good news, the problem is treatable. With prompt treatment, the symptoms go away within a few days or weeks, though the swelling usually will take longer to completely heal.

Even many times, conservative /home treatment is often enough to cope with. Typically, it is not more than lifestyle measures (such as resting the affected joint) and OTC painkillers to help soothe the pain.

But in some cases, the symptoms persist and become more difficult to improve. For such a case, the following additional treatments may be required (depending on the underlying cause and disease severity):

  1. Antibiotics, if the disease is caused by an infection (septic bursitis, for example).
  2. Corticosteroid injection, to help improve pain and swelling more quickly. One injection is usually enough – ask a doctor for more guidance!
  3. Physical therapy to help improve the muscle strength in area around the affected joint. Sometimes an assistive device, a walking cane for example to help minimize pressure on the affected area, may be suggested.
  4. In rare cases, surgery may be required to remove and drain an inflamed bursa.

Can rheumatoid arthritis cause bursitis?

RA is a chronic, systemic autoimmune disease. Normally, your immune system is responsible to protect your body from harmful invaders (such infectious organisms), reducing your chance of getting ill. But with autoimmune disease, this mechanism goes awry and doesn’t work as well as usual!

In people with RA, their immune system mistakenly attacks its own healthy body tissue. As a result, they can have widespread inflammation throughout the body. This is especially true if the disease is poorly controlled.

Curative therapy is not available, but some treatments can help drive the disease go into its remission. Fewer flare-ups (periods without symptoms or when the disease is inactive) mean the lower the risk of developing the complications. With prompt treatment, remission can occur in years and patient will still have an average expected lifespan.

At first, the disease usually attacks the smaller joints such as joints of hands and feet. Then it will affect larger joints – for examples; joints of wrist, ankle, knee, elbow, shoulder, and hips. Even poorly-controlled RA can cause inflammation in non-joint structures, causing other serious medical conditions (such as heart disease, lung disease, Sjogren’s syndrome, and lymphoma)! How about bursitis?

Again bursitis is usually caused by repetitive positions or movements that eventually make a bursa become inflamed. But there are also other factors /conditions that increase the risk, and rheumatoid arthritis is one of examples.

For examples, common conditions or repetitive motions that can lead to bursitis are as follows:

  1. Frequent leaning on your elbows for long hours.
  2. Prolonged sitting /kneeling on hard surfaces.
  3. Extensive, prolonged kneeling for certain tasks such as scrubbing floors.
  4. Frequent lifting something or reaching overhead may make a bursa of your shoulder gets hurt.
  5. Sport injury that causes trauma to a bursa, such as running without suitable shoes may irritate your ankle and hips.

In general, people with RA are at higher risk of developing bursitis than people without autoimmune disease. But RA is not the only one to blame. Your risk of having bursitis also increases with the following other risk factors: