Published on Nov 28, 2020 - 5 min read
Abstract
A painful condition that results in swelling or inflammation of the bursae, which are the fluid-filled, small sacs present in your joints, is called bursitis
A painful condition that results in swelling or inflammation of the bursae, which are the fluid-filled, small sacs present in your joints, is called bursitis. These bursae cushion the bones, muscles, and tendons in the joints. Each bursa is lined with synovial cells, which are the cells that produce a lubricant to reduce friction between the tissues in the joint. Your joints move easily because of this cushioning and lubrication.
The inflammation of the bursae makes the joint painful on pressure and movement. The joints commonly affected are the shoulder, hip, and elbow, but it can also affect the knee and heel. This condition typically affects joints that are used repetitively. An infection of the joint can also result in bursitis.
The treatment for bursitis includes rest and preventing further joint injury. Most people feel better in a few weeks with treatment but often suffer from frequent flare-ups.
Depending on the joint affected, the common types of bursitis are:
Elbow Bursitis - Otherwise called olecranon bursitis. It is the inflammation of the olecranon bursa present between the skin and elbow bones. It can result from constant pressure on the elbow.
Knee Bursitis - Also called goosefoot bursitis or Pes Anserine bursitis. This bursa is located on the inside of the knee between the shinbone and the hamstring muscles. It is caused by a lack of stretching, being obese, tight hamstring muscles, and arthritis.
Kneecap Bursitis - Otherwise called prepatellar bursitis. It commonly affects people who sit, taking the support of the knees (kneel).
Hip Bursitis - Otherwise called trochanteric bursitis. This type of bursitis commonly results from a hip injury, spinal abnormalities, overuse, and arthritis. It is common in middle-aged and older women.
Anterior Achilles Tendon Bursitis - Otherwise called Albert's disease. Injury, wearing shoes with a firm back extension, and disease of the Achilles tendon can result in this type of bursitis. Here, the bursa in front of the tendon in the heel gets affected.
Posterior Achilles Tendon Bursitis - Otherwise called Haglund's deformity. The bursa present between the skin of the heel and the Achilles tendon gets affected. It commonly affects young women.
Infectious Bursitis - Also called septic bursitis. Sometimes the bursae can get infected, resulting in swelling, pain, and fever.
The common signs and symptoms of bursitis include:
Joint swelling.
Joint pain.
Redness.
Thickening of the bursae.
Inability to move the affected joint.
If there is excessive joint pain, swelling, redness, or a rash with fever, make sure you consult a doctor right away.
Inflammation of your bursae usually occurs due to:
Repetitive motions or overuse.
Direct joint injury.
Direct impact or pressure over the area, such as repeated bumping or prolonged pressure on the knee due to kneeling.
Injury due to incorrect posture.
Activities, such as gardening, scrubbing, painting, shoveling, etc., can result in joint overuse or injury.
People who are suffering from gout, scleroderma, and rheumatoid arthritis are more prone to develop bursitis. This is because crystals form inside the bursae, which makes them swell.
Athletes, especially those who play tennis, golf, etc., are more likely to be affected by bursitis.
Infection can also sometimes cause bursitis. Bacteria can enter through a cut on the skin. People with a compromised immune system are more prone to this.
Stress from a poorly positioned joint due to leg length differences or arthritis.
Other conditions that can result in bursitis are psoriasis, thyroid problems, or drug reaction.
In some cases, the cause is not known.
Some other activities that can affect your joint are repetitive bending of elbows, overhead lifting, walking with ill-fitted shoes, sitting for long periods on a hard surface, and stretching.
Old age.
Systemic conditions like diabetes, gout, and arthritis.
Improper posture.
To diagnose this condition, your doctor will examine the affected joint, and he or she will ask you about any recent activities that might be responsible for the inflammation. In case you have a fever, the doctor might take a sample of fluid from the affected bursa. The fluid will then be checked for the presence of bacteria or crystals.
Sometimes, the doctor might ask you to get additional tests to eliminate other severe conditions that can result in similar symptoms. You might have to get an X-ray to rule out a fracture, a blood test to rule out rheumatoid arthritis, and CT or MRI to see if there is a ligament tear.
Most cases of bursitis get better on their own with some home remedies like:
Rest.
Avoid overusing the affected joint.
Cold compresses for two days after symptoms start to reduce swelling.
After two days, apply heat using a heating pad or take a hot water bath.
To reduce pain and swelling, you can try over-the-counter medications like Ibuprofen or Naproxen sodium.
Place a small pillow between your legs if you sleep on your side to cushion your knees.
If the pain and swelling are not getting better even after trying home remedies, then you might need:
Medication - If the lab reports of the sample collected from the bursae show bacteria, then the doctor will prescribe antibiotics.
Injections - If you have severe pain and swelling, the doctor will inject a corticosteroid into the bursa. This will give quick relief from pain and inflammation.
Physical therapy - A physiotherapist will teach you exercises to strengthen the affected joint muscles and ways to prevent a recurrence.
Walking Aids - To help relieve pressure from the knee or heel, the doctor might suggest using a cane or other devices to help you walk.
Surgery - Surgery is rarely done. Here, the inflamed bursa is surgically drained, and sometimes the affected bursae might be surgically removed.
It is not always possible to prevent bursitis, but the following tips might help reduce the risk of developing bursitis and prevent a recurrence:
If you are overweight, reduce weight to prevent extra stress on your joints.
Perform exercises to strengthen the joint muscles.
Maintain proper posture while sitting and standing.
If you experience pain, stop that activity immediately.
If your work requires you to perform repetitive activities, then take frequent breaks.
Always warm-up.
Bursitis usually improves with treatment, but in some, it can become a chronic or long-lasting condition. If you have pain in your joint, consult a doctor online, and start your treatment immediately.
Conservative treatment measures like adequate rest, applying an ice pack, and pain-relieving medications help relieve the discomfort caused by bursitis. However, if the conservative treatment fails, antibiotics, physiotherapy, corticosteroid injection, surgery, or assistive devices help.
Repetitive actions that pressurize the particular bursa of joints result in bursitis. These activities include throwing, leaning, and kneeling.
Untreated bursitis can lead to chronic pain and muscle atrophy. Chronic pain can be due to permanent enlargement of the bursa which thereby, results in reduced physical activity and atrophy of the adjacent muscles.
Vitamin B12 injections and foods containing omega-3 fatty acids help in alleviating the symptoms of bursitis.
- Processed foods.
- Salt.
- Eggs.
- Meat.
- Dairy products.
- Alcohol.
- Soft drinks.
- Vegetables like tomatoes, potatoes, bell pepper, etc.
- Citrus fruits.
- Animal fats.
- Caffeine.
Bursitis involves the temporary inflammation of the bursa, a fluid-filled sac in the joint, whereas arthritis is a chronic inflammation of the bones, joints, and cartilage. Also, bursitis occurs as a result of overuse, infection, or injury. On the other hand, arthritis is caused by normal wear and tear, which increases with age and also runs in families.
- Adequate rest.
- Applying ice packs for 20 to 30 minutes every four hours.
- Taking anti-inflammatory medications like Naproxen, Ibuprofen, and Celecoxib.
- Strengthening and stretching exercises.
Running, jumping, and other high-impact activities should be avoided in bursitis of the hip; instead, walking is recommended.
Walking on uneven surfaces increases the pressure, and so it is better to avoid it. On your doctor's advice, slowly start walking on a flat surface using supportive shoes, and make sure not to push beyond your limits as it can increase inflammation.
Strengthening exercises should be carried out on slow progression so that it does not cause tiredness and discomfort the next day. Also, make sure not to massage bursitis affected area.
Bursitis of the hip is characterized by pain and soreness, which radiate to the thighs on the same side. Also, the pain increases with walking, climbing stairs, etc.
Rest, applying an ice pack, over-the-counter pain-relieving medications, wearing a shoulder brace, and gentle stretching exercises help treat shoulder bursitis.
Bursitis of the shoulder is flared up at night because lying down on a particular side compresses the bursa further, leading to increased pain than it usually would be.
Aching, redness, swelling, and increased pain on movement or pressure are the manifestations of bursitis.
Bursitis of the hip usually takes about six weeks to heal. However, the recovery period may vary depending on the age, presence of other inflammatory conditions, and physiotherapy.
Last reviewed at:
28 Nov 2020 - 5 min read
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Dr. Patel Tejashkumar Govindbhai
Orthopedics And Traumatology
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