BURSITIS

Overview

Bursa is the small fluid-filled pads present all over the body to help gliding between the bones, muscles, tendons. Inflammation or irritation of these pads is called bursitis

These pads are mainly located around the shoulder, elbow, knee, hip (trochanter region). 

If the bursa becomes inflamed, this leads to fluid accumulation in the sac which causes pain, swelling and decreased cushioning function.

 

Different Bursa Locations

Olecranon bursitis:

Inflammation of the bursa of the elbow joint is often caused by leaningon the elbow for a long duration.

 

Subacromial bursitis

Inflammation of the bursa located between the acromion & deltoid muscle (superiorly) & head of the humerus (inferiorly) is often caused by repetitive overhead motion.

Pes anserine bursitis: Inflammation of the bursa of the inner knee  that is often caused by stress due to conditions such as obesity and degenerative joint disease 

 

Retrocalcaneal bursitis (also known as ankle bursitis or Achilles tendon bursitis) is a condition in which the retrocalcaneal bursa, a small cushioning sac between the heel bone and the Achilles tendon, becomes inflamed.

Prepatellar bursitis

Inflammation of the prepatellar bursa located between the skin and the patella that is most commonly caused by chronic strain on flexed knees (also referred to as “housemaid’s knee”) or repeated trauma (e.g., falling on the knee)

 

Trochanteric bursitis:

Hip bursitis is typically categorized by the area from which inflammation or irritation stems. 

When a trochanteric bursa is involved, the condition is termed trochanteric bursitis or greater trochanteric pain syndrome (GTPS); ischial bursitis, which is also known as ‘Taylor’s bottom’ or ‘weaver’s bottom’ affects the ischial bursa

Risk Factors

Age- Bursitis becomes more common with aging.

Occupations or hobbies- If your work or hobby requires repetitive motion or pressure on particular bursae, your risk of developing bursitis increases. Examples include carpet laying, tile setting, gardening, painting and playing a musical instrument.

Other medical conditions- Certain systemic diseases and conditions — such as rheumatoid arthritis, gout and diabetes — increase your risk of developing bursitis. Being overweight can increase your risk of developing hip and knee bursitis.

 

Symptoms

– Pain that ranges from dull to burning

– Excessive swelling, redness, bruising or a rash in the affected area

– Sharp or shooting pain, especially when you exercise or exert yourself

– Pain is often present while at rest and may be sufficient to wake a person who rolls onto the affected side during sleep

Diagnosis

Usually, clinical diagnosis is sufficient

  • Imaging tests 

X-ray images can’t positively establish the diagnosis of bursitis, but they can help to exclude other causes of your discomfort. 

MRI might be used if your bursitis can’t easily be diagnosed by a physical exam alone.

  • Lab tests

Aspiration of superficial bursas to rule out infection or gout

Treatment

Treatment depends on the severity of the symptoms. Typically, the first course of action is rest, anti-inflammatory medications, icing, and refraining from exercises that exacerbate the condition, such as running or climbing hills, until symptoms improve. Antibiotics maybe required if infection is suspected.

With prolonged symptoms, corticosteroid injections may be used to decrease inflammation in the affected area, the bursal fluid may be aspirated, or both may be done together. In individuals whose symptoms persist, surgery may be necessary to remove the inflamed bursa.

 

Preventions

  • Using kneeling pads. Use some type of padding to reduce the pressure on your knees
  • 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.