Article by John Miller
What is Bursitis?
Bursitis is the inflammation of a bursa.
What is a Bursa?
A bursa can be thought of as a self-contained bag with a lubricant and no air inside. If you imagine rubbing this bag between your hands; movement of your hands would be smooth and effortless. That is what a bursa is meant to do; offer a smooth, slippery surface between two objects.
Your bursa is found throughout your body where muscles and tendons glide over bones. You have more than 150 bursae in your body. These small, fluid-filled sacs lubricate and cushion pressure points between your bones and the tendons and muscles near your joints. Without the bursa between these surfaces, movements would be painful due to friction.
What Causes Bursitis?
When your bursa becomes inflamed, the bursa loses its gliding capabilities, and becomes more and more irritated and painful when it is moved. The added bulk of the swollen bursa causes more friction within an already confined space.
There are several common causes of bursitis. They include the following:
- repetitive bursa irritation
- traumatic injury
- systemic disease
Repetitive Bursa Irritation
Bursitis usually results from a repetitive movement or due to prolonged and excessive pressure.
Shoulder bursitis (subacromial bursitis) for example is caused by your the pinching of your shoulder bursa between your shoulder's rotator cuff tendon and the adjacent bone (acromion).
Trochanteric bursitis (hip bursitis) sufferers usually have weak hip muscles and tend to sway as they walk, which irritates your trochanteric bursa.
Similarly in other parts of the body, repetitive use or frequent pressure can irritate a bursa and cause inflammation.
Another cause of bursitis is a traumatic injury.
Following trauma, such as a car accident or fall, a patient may develop bursitis. Usually a contusion causes swelling within the bursa. The bursa, which had functioned normally up until that point, now begins to develop inflammation, and bursitis results. Once the bursa is inflamed, normal movements and activities can become painful.
A common traumatic bursitis is knee bursitis, which can occur when you fall and land on your knee.
Systemic inflammatory conditions, such as rheumatoid arthritis, may also lead to bursitis. These types of conditions can make patients susceptible to developing bursitis.
Common Types of Bursitis
- Bursitis Shoulder ( Subacromial Bursitis )
- Bursitis Hip ( Trochanteric Bursitis )
- Bursitis Knee ( Patella Bursitis )
- Bursitis Elbow (Olecranon Bursitis)
- Bursitis Heel (Retrocalcaneal Bursitis)
Bursitis treatment has several phases:
- reduce inflammation
- assess the cause
- prevent a recurrence.
Reduce Bursa Inflammation & Pain
Bursa treatment should commence with modalities to reduce inflammation and pain:
- Anti-inflammatory Medications
- Anti-inflammatory Gels
- Deloading taping eg kinesio taping
- Avoid activities that reproduce your pain
Assess Non-Traumatic Causes
Bursitis pain usually settles within a few weeks with proper treatment. Recurrent flare-ups are common and can be frustrating. All non-traumatic origin bursitis should be investigated to discover what is causing your bursitis. As mentioned earlier, the source may be poor biomechanics or movement habits that your physiotherapist can correct. Secondly, the cause may be disease related. Your doctor may perform some blood tests etc to eliminate or confirm a systemic cause of your bursitis.
Prevent a Recurrence
Bursitis is usually a symptom caused by many other factors, that if you don't solve, will render you vulnerable to recurrences. Your physiotherapist is highly trained in identifying the biomechanical or training causes of bursitis.
Your physiotherapist will recommend a stretching, movement correction / control and strengthening program after a thorough assessment. To quickly solve your pain and stop it returning again, we recommend that you seek the advice of your local physiotherapist.
Bursitis Related Injuries
Helpful Bursitis Treatment Products
Bursitis Treatment Options
Persistent or Chronic Bursitis
Persistent or chronic bursitis may find a corticosteroid injection beneficial. There are some side effects related to corticosteroid injection esp diabetics. You should consult your doctor for an opinion before injecting your bursa.
Bursitis occasionally persists despite all of the best efforts of your medical team. In these cases, a bursectomy (surgical removal of your bursa) may be considered.
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