What You Need to Know About Bursitis

Overview

Bursae are fluid-filled sacs located around the joints. They are found in the junction where the tendons, skin, and muscle tissues meet the bone. They provide lubrication and help to prevent friction during movement.

Bursitis is an inflammation of the bursae. When bursae are inflamed, it causes pain and swelling and reduces mobility around the area.

Symptoms of bursitis

Common symptoms include pain, swelling, redness, and thickening of the bursae. Symptoms of bursitis are dependent on the location.

  • Pre-patellar and olecranon: here, it would be hard to bend the leg or hand respectively.
  • Trochanteric and retro-calcaneal: causes difficulty in walking, trochanteric bursitis can also make it painful to lie on your hip.

Types of bursitis

The condition can be acute or chronic depending on how frequently they occur. It is acute if it occurs suddenly and chronic if it occurs regularly.

Based on the site of occurrence, bursitis can be Pre-patellar, Olecranon, Trochanteric, and Retro-calcaneal.

Pre-patellar bursitis occurs around the patella or kneecap and it may either be acute or chronic.

Trochanteric bursitis occurs gradually. It affects the bursa of the hips and is usually associated with other medical conditions such as arthritis.

Olecranon bursitis is an inflammation around the olecranon located at the tip of the elbow. It is usually chronic and some small nodules may be felt within the bursa.

Retro-calcaneal bursitis is an inflammation that occurs around the heel. It may be acute or chronic.

When bursae show inflammatory symptoms such as redness, swelling and heat alongside fever, chills and other signs of infection, it is said to be septic.

Causes of bursitis

Each type of bursitis has a specific cause although the major cause of bursitis is an injury to the bursae. An injury to the bursae can result in inflammatory symptoms such as pain, swelling, and redness of the affected area.

Pre-patellar bursitis

An injury to the knee cap can cause swelling. Other possible causes include sport-related injuries, repeated knee bending, infection, staying on the knee for long, bleeding in the bursae.

Trochanteric bursitis

Inflammation of the hip bursae can be triggered by things such as lying on the hips for a long time, injury, maintaining an improper posture while standing or sitting, bone disease such as arthritis.

Olecranon bursitis

Inflammation of the olecranon bursae can be caused by repeatedly resting the elbow on a hard surface or a hard blow to the back of the elbow. An infection or gout can also cause this type of bursitis.

Gout occurs when there is a buildup of uric acid crystals in the body. This can subsequently cause tophi which are small nodules that can be felt within the bursae.

Retro-calcaneal bursitis

The heel bursae can become inflamed when subjected to repetitive activities such as running or jumping. Other causes may include wearing very tight shoes or exercising strenuously without adequate warm-up.

Septic bursitis

This occurs when the bursae are inflamed due to infection by bacteria which may be introduced into the bursae through a breach in the surrounding skin.

Infectious bursitis can be caused by cellulitis, blood infections, or joint infections.

Risk factors for bursitis

The likelihood of developing the condition increases with the following conditions:

  • Aging
  • Chronic medical problem
  • Improper posture
  • Repetitive use of a joint
  • Engaging in repetitive sports or activities
  • Infection
  • Injury to the bursae

Diagnosis

Diagnosis can be made clinically via physical examination but tests can also be used to make a diagnosis.

Tests such as X-ray or ultrasound can be used to take image of the affected bursae. Blood and other samples can be taken from the bursae for diagnosis.

Where an infection appears to be restricted to a joint, needle aspiration is recommended.

Performing a needle aspiration may possibly increase the risk of translocation of a secondary infection from the skin into the bursae, in such instance, empirical therapy should be instituted by giving antibiotics and the patient should be observed clinically rather than performing a needle aspiration.

Treatment of bursitis

Symptoms can be relieved by rest, pain medication, and ice therapy. However, other possible treatments include:

Antibiotic therapy for infected bursae, corticosteroid, and home-based exercises.

Prevention

The condition isn’t preventable although certain lifestyle changes will reduce the likelihood of developing it and also prevent serious flare-ups. These include:

  • Preventing extra stress to the joints by maintaining a good weight.
  • Exercises that help strengthen muscles around the joints
  • Warm up before starting strenuous exercises
  • Taking frequent breaks when engaging in repetitive tasks
  • Maintaining good posture when sitting and standing
  • Discontinue an activity if you experience pain

Long-term outlook

Bursitis can become chronic if it is left untreated or caused by an underlying health condition that cannot be cured. When treatment is commenced, the condition will likely improve. Talk to your doctor if you still experience symptoms with treatment.