Often you’ll hear people—even doctors—using the terms arthritis and bursitis interchangeably. But there are major differences between arthritis and bursitis. And although many of the symptoms are similar, each condition involves different structures within the body and each requires a unique treatment approach.
Types of Arthritis
The most common form of arthritis is osteoarthritis, but other types of include:
- Rheumatoid arthritis, which is an autoimmune disease that can occur at any age. Rheumatoid arthritis affects multiple joints, especially the smaller joints in the hands, wrist, and feet, and the same joints on both sides of the body are often affected. In addition to joint pain, there is very often swelling and extreme tenderness. Triggers include changes in the diet and stress, or the condition can manifest quickly for no apparent reason.
- Infectious arthritis results from an infection within the joint. Symptoms include inflammation and tenderness, as well as fever and sometimes chills. The infection is most often a result of an injury or infection either to the joint itself or elsewhere in the body.
- Juvenile arthritis occurs in younger individuals and can have symptoms like intermittent fever, joint stiffness, and swelling in several joints. Anemia, weight loss, and loss of appetite are other symptoms. Oftentimes it will be accompanied by a blotchy rash on the arms and legs.
Osteoarthritis is often called “wear and tear” arthritis because with age, joint cartilage surfaces very often begin to degrade, thin, and wear out. Unlike the other forms of arthritis, osteoarthritis comes on slowly and gradually worsens over the years. Affected joints are typically ones that have been either abused (sports, etc.) or ones that haven’t been moved through their range of motion regularly.
Prior joint injuries make these joints more susceptible to arthritis in later years. This is particularly true when the joint was immobilized or wasn’t rehabbed correctly with range of motion exercises, nutritional support, and strengthening of the stabilizing muscles.
Common symptoms of osteoarthritis include:
- Joint pain
- Stiffness upon waking or after sitting for a period of time
- Inability to move the joint through its complete range of motion
- Popping or grating sensation within the joint during movement
- Bony lumps or spurs that form around a joint
Bursitis Vs. Arthritis
The main difference between arthritis and bursitis is that osteoarthritis affects the joints, while bursitis affects the small sac-like structures that are located next to joints, called bursa. Bursitis is the inflammation of the bursa.
The bursa contain fluid that is meant to provide a lubricating cushion where a muscle or tendon rubs over another muscle or bone during movement.
Unlike the gradual development of osteoarthritis, bursitis comes on quickly—typically within a few hours or the next day. Bursitis can happen after spending hours doing any kind of repetitive movement (washing/waxing the car, digging in the garden, washing windows, etc.).
The most familiar areas for bursitis are in the shoulder and elbow. A very common way to inflame bursa is by playing tennis or golf, especially after being sedentary for months. The swinging motion during these activities requires the muscles surrounding the elbow to rub over the bony joint, causing the lubricating cushion to become inflamed. It is such a common occurrence that the bursitis in this area is referred to as “tennis elbow” or “golfer’s elbow.” These same activities can inflame bursa in the shoulder as well (called sub-deltoid bursitis).
Bursitis can also occur in the hip (trochanteric bursitis) as well as the knee. And although it’s not that common, improperly fitting shoes or high heels can result in heel bursitis, or heel spur.
Fortunately, bursitis can be a short-lived problem if you take care of it quickly. But even if it’s a chronic problem, it can still be resolved by following the right program:
- Minimize movement. Resting the affected area is essential. Bursitis in the shoulder can be challenging since the weight of the arm is constantly pressing on the bursa, even when the shoulder isn’t being moved. A sling can be especially helpful for restricting movement and taking pressure off the bursa. If the bursitis is in the hip, knee, or foot, it is imperative to get off your feet and rest.
- For acute conditions, ice the area. For the first 24 to 48 hours, apply the ice pack for 15 minutes, then remove it for 15 minutes. Repeat this on/off pattern for at least an hour, twice daily.
- For chronic bursitis, alternate ice and heat. Use the ice packs as outlined above, but after 48 hours alternate the ice packs with moist heat. (Use the ice pack for 15 minutes followed by moist heat, such as a hot towel or waterproof heating pad and moist cloth, for 15 minutes.) Do this for at least an hour, twice daily.
If the same bursa has been inflamed several times, treating it can become more involved. In an attempt to strengthen bursa that have been repeatedly damaged, the body will often begin to deposit calcium within the bursa. These small spicules of calcium are often noticeable on X-rays. The spicules are like ground glass, and the more you move the area, the more painful it becomes.
If you’ve had bursitis in one area for months or years, chances are greater that you have these calcium deposits. There are a few techniques that can be used to remove these deposits, lessen the pain, and help prevent future problems.
- Apple cider vinegar. One method is to slightly acidify the body by taking 1 tablespoon of apple cider vinegar in a glass of water daily.
- B12 injections. If you have access to them, one of the quicker methods of removing these calcium spicules is with intramuscular (not into the bursa) injections of vitamin B12. The recommended dosage is 1,000 micrograms daily for 7–10 days, then 3 times a week for 2–3 weeks, then once or twice a week for 2–3 weeks. The consistency and frequency of these injections are important. Increasing dosage and decreasing frequency isn’t as effective.
- B12/DMSO combo. I have also had success combining equivalent amounts of liquid vitamin B12 with a small amount of DMSO, and topically applying that to the affected area.
- Ultrasound treatment to the involved bursa can help remove calcium spicules.
Conventional treatment usually involves anti-inflammatory medications such as NSAIDs. And in chronic cases, injections of glucocorticoids (steroid injections) are usually given. These will provide almost immediate relief. But the problem is, many people resume activities and further damage the area because they feel the problem has been resolved when it really hasn’t. Repeated injections often lose effectiveness, and surgery is the next step. I don't recommend this course of action, especially when there are better natural therapies, such as the ones I’ve discussed here.