What is Bursitis?
Bursitis is an excruciatingly painful condition that causes your joints to swell and become tender. This happens when the small fluid-filled cavities or sacs called bursae located near the bony joint become swollen and inflamed. The fluid from bursae curtails the friction caused by muscles and tendons when they move against the skin and bones and facilitate movement. The human body has over 160 bursae and they are mainly located next to the tendons near the large joints like shoulders, elbows, and hips. Their main function is to cushion and lubricate muscles, tendons, and bones near the joints. The bursa lies flat, conforming to the shape of your bone. When it becomes irritated, it can swell up and become enlarged. Bursitis is not a life-threatening condition but can lead to immense pain and can be extremely uncomfortable. It can also restrict movement. If left untreated, chronic bursitis can lead to calcium build-up in the soft tissues, resulting in permanent loss of movement in the affected area. Some of the more common places bursitis occurs are elbows, buttocks, ankles, shoulders, thighs, hips and knees.
Causes of Bursitis
Bursitis is simply the accumulation of fluid in the bursa sac. Bursitis is primarily caused by repetitive movements or sports injury. The bursa cavity is made up of a membrane called synovia, which produces a fluid inside the bursa cavity. Inordinate friction, trauma and many other conditions may cause the synovia to become inflamed. But there are various other reasons for bursitis to occur as well.
- Underlying disorders such as pseudo gout and gout.
- Joint deformities or differences in leg length may put strain on the soft tissues that can cause bursitis.
- Poor body posture or improper gait may also be a culprit.
- Diabetes is also a known contributor for bursitis.
- Certain medications may promote side effects that ultimately result in bursitis.
- Excessive strenuous activities and sustained pressure from kneeling on hard surfaces could be another reason.
- Inflammatory conditions like rheumatoid arthritis and systemic lupus erythematous can also be blamed for the condition.
- Bursitis can also be caused by infection and is known as septic bursitis.
Symptoms of Bursitis
The most common parts of the body affected by bursitis are the shoulders, elbows, knees, hips, and feet. Symptoms include pain, tenderness, swelling, stiffness and sometimes redness and warmth around the inflamed bursa. The symptoms go away by themselves with rest or self-treatment. However, there are times symptoms do not respond well to traditional methods. Medical intervention is then required. Since pain occurs near the joints, bursitis is also often mistaken for arthritis.
Types of Bursitis
Bursitis can occur anywhere in the body where a bursa sac is located. There are some specific types of bursitis, which we will list below:
Albert's Disease or Anterior Achilles Tendon Bursitis
This condition is caused by inordinate stress on the Achilles tendon. Injury, disease, or wearing poorly fitting shoes with a hardback support aggravates these types of bursitis. When the bursa sac located where the tendon attaches directly to the heel becomes inflamed, swollen and painful, it results in anterior Achilles tendon bursitis.
- Pain, swelling and warmth around the heel.
- Difficulty in walking, and also wearing certain types of shoes.
- Over time, swelling on the anterior portion of the Achilles tendon extends medially and laterally resulting in this type of bursitis.
Posterior Achilles Tendon Bursitis
Walking that repeatedly presses the soft heel tissue against the hardback support of a shoe causes posterior Achilles tendon bursitis. This type of bursitis is more common among women, but can occur in men as well. Shoes such as high-heeled pumps that taper sharply inward towards the back of the heel can cause enlargement of the heel bone resulting in posterior Achilles tendon bursitis.
- Soreness, redness, and warmth at the back of the heel.
- Wearing or erosion of the top layer of the skin.
- Over time a tender lump of 1 to 3 cm in diameter may develop.
Elbow Bursitis, also called Tennis Elbow or Popeye's Elbow
You can develop this condition playing golf or tennis. Elbow bursitis could also be caused by leaning on the elbows for long periods of time, or by falling on the elbow. People with elbow bursitis develop a squishy lump on the back of their elbow. Elbow bursitis is more common in older people, particularly in men and more often in their dominant arm.
- Swelling is the first symptom you will notice. Swelling becomes large and looks like a small ball at the tip of the elbow.
- It is excessively painful to bend the elbow. Although, there is no pain when the elbow is fully extended.
- Redness around the elbow.
- Increased sensitivity in and around the elbow.
- Pus draining from the infected bursa.
In this condition the outside part of the hip called the “greater trochanter” gets inflamed and causes immense pain in the hip. Some of the causes of hip bursitis are hitting your hip on something, falling down, or even lying on one side for extended periods of time. Hip bursitis can also be caused by standing for long hours, climbing or running up stairs and even by artificial implants in the hips. A previous surgery around the hip can also result in this painful condition.
- Shearing pain in the lower part of the hip.
- Pain becomes worse after sleeping or sitting at one place for extended periods.
- Tenderness extending down the side of the hips.
- Pain that gradually radiates down to the thighs and other parts of the legs.
- Some people may feel feverish, tired and sick.
Knee bursitis causes the bursa located near the knee joint to become inflamed. Knee bursitis mostly occurs over the kneecap, or below the joint on the inner side of your knee. This condition causes immense pain and can greatly reduce mobility.
- Increased pain when kneeling.
- Swelling over and below the kneecap.
- Redness and warmth in the affected area.
- Repetitive bending, squatting, and crouching escalate these symptoms.
Treatment For Bursitis
Use of Corticosteroids injections
When symptoms do not improve, you should see a doctor. Your doctor may prescribe medicines to decrease the inflammation. Most of the time, doctors prescribe corticosteroids to minimize inflammation and ease the pain. Corticosteroids are usually injected directly into the affected area. When these injections are not immediately or overly effective they have to be taken repeatedly, sometimes for months. The prolonged use of corticosteroid injections often have other side effects that mask the real reason for the problem, that need to be treated differently. Excessive use of corticosteroid’s, especially for long periods of time can also raise blood pressure and augment the risk of developing an infection.
Exercise and physical therapy
Exercising strengthens the muscles in the affected area. This strengthening of the muscles in the affected area relieves strain, reducing pain and preventing recurrence. Your doctor may also refer you to a Rheumatologist, an Orthopedic Surgeon or a Physical Therapist for specialized treatment. If bursitis is not treated properly, it is possible to permanently damage your joints and lead to disability. A physical therapist may suggest several therapies to relieve the condition such as hot and cold treatments and laser or water therapy. A physical therapist will suggest you do an array of different exercises to improve flexibility and relieve stiffness. Physiotherapy normalizes muscle lengths, and strengthens your knee muscles, hamstrings and quadriceps and decreases the likelihood of re-aggravating the condition.
An Occupational Therapist may recommend the use of hand and wrist splints isolating or restricting movement. They might also suggest the use of assistive devices to help make daily activities easier. Bursitis is primarily caused by muscle overuse so splints, braces, and slings allow the affected area to be immobilized. This rest reduces the pain.
When bursitis does not respond to other treatments, surgery may be another option, although it is rarely required. The inflamed bursa is surgically drained to ease the condition.
Self-care for Bursitis
Bursitis can be treated in a myriad of ways and treatment depends on the severity of the symptoms. Following the self-care techniques below can often allow you to treat bursitis at home:
- Stop doing the activities that escalate the problem and modify your daily routine. Avoid activities like golf, tennis and heavy lifting. Wrong or excessive movement and pressure can aggravate and prolong the symptoms.
- Only use or move the affected limb or muscle group when absolutely necessary.
- Apply ice packs wrapped in a towel on the affected area to decrease swelling and pain. Cold compress decreases inflammation by reducing blood flow to the affected area. It also provides temporary relief by decreasing nerve activity and promotes healing in the inflamed bursa.
- Some over-the-counter anti-inflammatory medicines such as Ibuprofen, Aspirin, and Naproxen can be taken to relieve discomfort. Since this is an inflammatory condition, we might suggest trying a topical, herbal compound such as Clear Koala at the first sign of injury or discomfort. Products like Clear Koala can be used over longer periods of time without lingering long-term side effects.
- To relieve hip and leg pain, put a small pillow between your legs while resting or sleeping. Keeping the affected area elevated can decrease the accumulation of blood in the affected area and help in reducing inflammation.
- Maintaining a healthy weight reduces the pressure on the painful and swollen joints as well. Loosing extra weight can be difficult for many people, especially as we age. If you drink coffee, and would like to shed a few pounds, check out our phenomenal weight loss coffee.
- Usually a warm bath or a hot compress feels really good on this type of injury or pain. Common treatments will often incorporate both a cold compress to reduce the swelling first, then a hot compress to increase blood flow, which improves circulation resulting in less discomfort, and reduces stiffness.
As with so many aches and pains, there are many underlying causes and reasons it may be there. It might be a good practice to evaluate the pain and why it is there… it will most likely be to warn our bodies to take it easy on that area, and the intensity of that pain correlating directly with the amount of healing that needs to take place. Once that message is received and has been acknowledged, selecting the proper method of managing it is up to you. Proper treatment will ultimately affect your ability to function in life. Consider all options, and choose wisely.