alt=X-ray view of a body with inflammation at the hip joint

The Bursitis Burn

The bursitis in both of my hips has been flaring up again lately and I'm not happy about it--especially when I try to sleep and can't lie on either side of my body. While bursitis is not RA and doesn't affect the joints, it is an inflammatory condition and comorbidity of RA. I didn't develop bursitis until I had RA for at least a few years. Once you have one chronic inflammatory condition, I've learned it's not rare to develop other ones-- from personal experience, medical research, and news I've read.

What is bursitis?

According to the Mayo Clinic, "bursitis is a painful condition that affects the small, fluid-filled sacs —called bursae— that cushion the bones, tendons and muscles near your joints. Bursitis occurs when bursae become inflamed.1

My diagnosis

I think I first developed bursitis not too many years after being diagnosed with RA. I seem to recall thinking that my hip pain was RA pain and inflammation of my hip joints, which filled me with worry as a young 20-something. However, at some point later I found out that it wasn't RA in my hips, but instead bursitis. Great news, right? I guess so. Well, it is better news than having RA-inflamed hips because at least my hips aren't in danger of becoming damaged. Bursitis, as I understand, is just extra pain that I need to deal with somehow. Luckily it comes and goes, and waxes and wanes, instead of the unrelenting nature of RA inflammation and pain.

The connection to RA

Interestingly, and not surprisingly, I often see a correlation with RA flare-ups and bursitis flare-ups. This makes sense that if my immune system is revved up and causing RA inflammation, my entire body itself is probably inflamed.

Another interesting pattern I've seen is that my bursitis has flared up quite severely after getting the mRNA Covid-19 vaccinations. I recently received my second booster (4th shot) and once again the burning, stabbing pain in my hips returned. The bursitis pain seemed to feel even worse than the full-body joint pain I experienced after all of my vaccinations. Strange, right? Why do my bursae freak out from these vaccinations, even worse than my RA does? Once again the answer to almost all of my questions is: who knows?

Bursitis flares

If you are fortunate enough to not be afflicted with painful, chronic bursitis, what does a flare actually feel like? When the flare-up is really bad, I feel a constantly sore, throbbing, burning sensation in both hips, even if I'm not putting any pressure on them or touching them. They just radiate pain (which is what's happening right now as I write this).

Sleep trouble

The pain also seems to get or feel worse at night when I'm trying to fall asleep in bed. Maybe it's more noticeable because it's dark and quiet and there aren't distractions going on around me, I don't know, but simply trying to lie on one side of my body or the other doesn't work out very well. It's incredibly painful with stabbing pain shooting down my legs. The pain becomes unbearable quickly and I have to roll over and get my weight off of that hip. Then I'll usually try lying on my other side, because I'm a side-sleeper and can't fall asleep lying on my back. But rolling over to the other side doesn't work very well either when I'm having a bursitis flare-up.

Sleeping becomes a fitful night of flip-flopping, shifting positions, lifting my legs up and down, and even lying on my stomach (that doesn't last very long). Needless to say, having bursitis in both hips makes sleeping extremely challenging and often just plain miserable.

Flare prevention tips

If you suffer from bursitis, what can you do about it? Is there anything that helps? According to the Mayo Clinic, some prevention tips include:1

  • Using kneeling pads
  • Use some type of padding to reduce the pressure on your knees if your job or hobby requires a lot of kneeling.
  • Lifting properly. Bend your knees when you lift. Failing to do so puts extra stress on the bursae in your hips.
  • Wheeling heavy loads. Carrying heavy loads puts stress on the bursae in your shoulders. Use a dolly or a wheeled cart instead.
  • Taking frequent breaks. Alternate repetitive tasks with rest or other activities.
  • Maintaining a healthy weight. Being overweight places more stress on your joints.
  • Exercising. Strengthening your muscles can help protect your affected joint.
  • Warming up and stretching before strenuous activities to protect your joints from injury.

They can be unpredictable

Sometimes bursitis flare-ups can't be prevented. In the past, my rheumatologist has given me cortisone injections into the bursae of both hips. This usually helps calm down the flare-up for a couple months and sometimes it completely goes away for a while. Similar to RA, bursitis can be an unpredictable and finicky thing to figure out, which is often maddening.

Does anyone else with RA out there also have bursitis? I'm curious to hear if you do and how it affects your body and your life. I know I can't be the only one fighting against my inflamed bursae in addition to my painful joints.

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