Bursitis: Symptoms, Causes and Treatments

Bursitis is a very serious health issue that needs to be treated properly. In this guide, we will discuss every aspect of Bursitis and the possible treatment options available.

Symptoms of Bursitis

The bursae are small sacs in your knee that are filled with fluid. Their purpose is to decrease friction between the tendons and the bones. If those sites get inflamed their fluid content increases and you’re dealing with bursitis.

Symptoms of Bursitis usually depend upon the part of the body that has been inflicted and generally the symptoms vary from person to person and not fixed kind. However, some characteristic features have been identified which could help you diagnose the disease.

The symptoms of bursitis include discomfort, pain, and swelling in the area where a bursa is located. Usually, the symptoms are worse after activity.

There are several bursae around the knee joint: the prepatellar bursa in front of the patella, the pes anserinus bursa on the inside of the leg about two inches below the patella, and the infrapatellar bursa, which sits right under the patella. You may also feel stiffness when you move the joint and there could also be swelling, as well as redness.

The most common thing resulting from Bursitis is pain. Now this pain can either build up gradually or there can be a sharp or sudden rise in the pain if there is any kind of calcium deposits. In adhesive capsulitis, which is the condition in the shoulder in which there is a loss of movement in the shoulder region and it gets frozen is also a sign of bursitis.

In Bursitis of the knee, it could become really difficult for you to lay down with both the knees touching each other. It can also happen due to the bursa filling up due to some injury or when there is some kind of crystal deposition in the knee region.

The knee becomes inflamed and it is mildly painful compared to conditions like arthritis and some range of motion is preserved. These conditions are usually referred to as roofer’s knee or carpet layer knee, resulting from direct trauma to the front end of the knee.

Inflammation and Swelling:

The symptoms are related directly to the amount of inflammation present in the bursa. Bursa is the fluid sac that prevents friction between tissues of the body during movement. Localized pain and tenderness can very well result from an inflamed bursa. This can result in stiffness or localized swelling as well and is often accompanied by some warmth or the reddening of the affected area. In case there is inflammation it becomes really difficult and painful to support the pressure of the body.

Hip Bursitis and Adhesive Capsulitis:

For example in the bursitis of the hip, which is amongst the most painful, either the ischial or the trochanteric bursa can get inflamed and there is pain and stiffness around the hip joint. Located on the side of your hip, is the trochanteric bursa and is separate from the actual joint through bone and tissue. When suffering from hip bursitis it could become difficult for you to lie on that side of the hip.

The most common thing resulting from Bursitis is pain. Now this pain can either build up gradually or there can be a sharp or sudden rise in the pain if there is any kind of calcium deposits. In adhesive capsulitis, which is the condition in the shoulder in which there is a loss of movement in the shoulder region and it gets frozen is also a sign of bursitis.

In Bursitis of the knee, it could become really difficult for you to lay down with both the knees touching each other. It can also happen due to the bursa filling up due to some injury or when there is some kind of crystal deposition in the knee region.

The knee becomes inflamed and it is mildly painful compared to conditions like arthritis and some range of motion is preserved. These conditions are usually referred to as roofer’s knee or carpet layer knee, resulting from direct trauma to the front end of the knee.

Summary:

In all cases of bursitis, whether it is of the knee, the hip or the shoulder the major symptoms include inflammation, pain, frozen joints and lack of movement of the effected part besides swelling and redness.

 

Main Causes of Bursitis

Bursae are nothing but fluid-filled cavities located near joints where tendons or muscles pass over bony projections. They help in providing a frictionless smooth movement. Being an inflammatory disease of the joint, the risk factors that can lead to bursitis and the underlying causes are very much interrelated. Bursitis can have a variety of causes including overuse, injury, infection, and even rheumatoid arthritis or gout.

The influencing risk factors that play a great role are –

  • Age plays a great role in acquiring bursitis. With increasing age, the body undergoes various degenerative changes. The lowered immune system also plays a significant role in that regard. That is why; bursitis is more common in individuals above the age of 40 yrs.
  • Occupations or hobbies that involve repetitive movements of the joint for e.g. throwing a baseball, extensive kneeling like in the case of housemaids, leaning on your elbow for a prolonged period of time, gardening, carpeting, etc
  • Certain medical conditions already cause stress in the body and have a preponderance of multiple inflammatory foci in the body. This, in turn, predisposes to bursitis. Such diseases are rheumatoid arthritis, gout, diabetes mellitus, psoriatic arthritis, thyroid disease.
  • Incorrect posture as well as inadequate conditioning before starting exercises can also contribute to bursitis.

Knowing about the various responsible factors involved in the disease process goes in a long way towards diagnosis and prevention of the disease.

The site involved in the disease process also goes a long way in predicting the course of the disease.

  • Knee joint – there are three bursae surrounding the knee joint, out of which, the prepatellar bursa is more commonly involved mainly as a result of direct trauma inflicted on that area. The involvement of this joint is more commonly involved with occupational hazards for those who spend prolonged periods of time sitting on their knee. Also, septic involvement due to some infections like rheumatoid arthritis can lead to knee bursitis.
  • Hip joint – hip bursitis is usually a non-infectious disease and is mainly due to local soft-tissue trauma or strain injury. The inflammation of the hip bursa is mainly due to the accumulation of the crystals of gout and pseudogout.
  • Shoulder joint – inflammation of the shoulder bursae occurs mainly as a result of subtle injuries such as the lifting of a grocery bag into the car.

Summary:

The various conditions causing bursitis are usually linked to age, occupation, or medical conditions already causing stress in the joints. These can also be due to the accumulation of fluid or crystals in certain areas and depend on the infected region.

Treatment Options for Bursitis

The treatment much like the symptoms and causes depends upon the location or the site that has been affected and the reason behind that. It also varies from person to person and treatment for kids is usually different from that used for adults. Neither is the treatment unique and often requires great care and precaution from the side of the patient besides adhering to the prescribed treatment or medication.

The conventional treatment for bursitis includes the RICE protocol as a first response treatment, administration of non-steroidal anti-inflammatories, and aspiration of the joint (draining fluid from the affected bursa). Your healthcare provider may also choose to use antibiotics if there’s an infection.

At home, you can treat your bursitis by ceasing the pain-inducing activity and making sure your diet does not cause inflammation in your body. Additionally, you should wear soft knee pads if you are kneeling a lot or do activities that entail the application of external force to the knee (e.g., martial arts). Observe which activities worsen the pain and strive to avoid those whenever possible.

For example, knee bursitis might get worse overnight if you sleep on your side. In that case, you should either sleep on your back or place a cushion between your knees.

Bursitis can be treated in a number of ways, these usually include:

  • The aggravated area should be avoided from indulging in any kind of activities. You shouldn’t expose it to much physical strain or movement.
  • The injured area must be properly rested and you should take care to not put any kind of stress on that region.
  • The area must be iced and that on a regular basis right from the day of the injury.
  • One could also resort to over–the–counter medicines that are used for anti-inflammatory treatments.

CorticoSteroids:

If the condition hasn’t improved in a span of a week, maybe consulting a doctor is not too bad an idea. The doctor can prescribe you some drugs which can help reduce inflammation. Corticosteroids are often used as they reduce pain and inflammation quickly. They are one of the safest modes of treatment and can be applied directly at the site of the problem. In case of the case is recurring, however, it is not advised to use the steroids again and again as it could be harmful to your health.

Physical Therapy: Another method that is usually employed is physical therapy. It is especially used in the case if a patient has a frozen shoulder. The treatment uses a wide range of motion exercises and use of forearm or thumb splints and/or bands.

Surgery

In case Bursitis hasn’t responded to any kind of treatment taken, including the use of steroids and through a prolonged use of physical therapy, then surgery could be an option. But one must resort to this option only and only when the condition is not responsive to any other kind of treatment. In this case, the affected region is usually operated upon by the surgeon and if there is a fluid stagnation or deposition of some crystals, then those are usually removed during the surgery.

Summary:

The treatment is not extensive and usually involves proper rest for the inflamed part and resorting to physical therapy of some kind.

Alternative Treatment

Besides the regular forms of treatment using adequate rest and not resorting the inflamed part to any kind of physical activity or stress there are some other forms of treatment also available for Bursitis. If physical therapy and normal methods like icing of the part have not responded to well and redness or swelling is still experienced then one may look for some other forms of treatment.

Also, the mode of treatment usually depends upon the fact of there is any infection of any kind or not. The non-infected cases would have responded to ice-compression and anti-inflammation or pain steroids and adequate rest. In some cases it also requires the aspiration of the fluid of the bursa.

Aspiration:

The process involves the removing of apportion of the bursa fluid from the affected spot through an injection or a needle, but under sterile conditions. This should be done under medical supervision only. In few cases this fluid is further sent for tests and analysis in the laboratory.

If the bursitis is non-infectious then the treatment form to be used can also be cortisone injection into the swollen area. This procedure is sometimes performed along with the aspiration process and typically has been found to reduce the swelling of the inflamed portion.

Bursectomy and antibiotic-intravenous- injection:

If the bursitis is septic then it may require evaluation an aggressive form of treatment. The bursal fluid is taken to the lab to examine the microbes responsible for the infection. It could also ask for antibiotic therapy which is to be done intravenously sometimes.

There could also be a need for repeated procedure of aspiration to be done for draining out the bursal fluid. Bursectomy is the procedure where there is surgical drainage of the fluid or alternatively the removal of the sac that is infected. The adjacent joints function normally after t the healing of the surgical wounds, but risk factors exist.

Nonsteroidal anti-inflammatory drugs or the NSAIDs in the form of ibuprofen can also be used for helping the inflammation and pain. Muscle atrophy, can also be caused as a result of bursitis an there are special exercise that need to be done to increase the mobility and build up strength again.

Summary:

If bursitis does not respond to the normal forms of treatment then procedures like bursectomy and aspiration can be used and patients can take use of NSAIDs and extensive exercises.

Preventive Measures

Even though not all forms of the disease can be prevented, one can reduce the risks related to some of them and reduce the chance of flare-ups by using a few preventive measures:

Use of Kneeling pads:

If your occupation or hobby involves any activity where you have to kneel extensively, like for hours, then you should use some kind of padding so that the pressure on your knees is reduced.

Properly lifting:

It is important to bend the knees properly while you are lifting. If you don’t do that then this results in extra stress for the bursae in the hips.

Taking breaks frequently: If the tasks that you are performing require heavy pressure or stress on the joint and on bursae , then you might consider taking frequent breaks and interval between activities or change activities every now and then so that there is no sustained pressure for a very long time.

Wheeling of heavy loads: If the activity or task that you are performing, involves the requirement of carrying heavy loads thereby putting extra stress on the shoulder bursae, then you should resort to using wheel carts and dolly or rolling them instead of putting the entire strain on your shoulder joints.

Walking around:

Being lazy was never good for your health, now it has been proved so. Sitting for long in any position, especially on hard surfaces will put extra pressure on the bursae in the hips and the buttock region. Therefore, such activities must be avoided.

Exercise:

If the muscles are strong then the chances of bursitis reduce.  Therefore, it is imperative that you do regular exercise to build up the strength and maintain their mobility. Increased strength will help protecting the affected joints.

Maintaining healthy weight:

If you are overweight, you are bound to put extra pressure on all your joints and this will increase the risk to bursitis. Staying fit can help you reduce a lot of problems.

Warming up and stretching properly before you involve yourself in any kind of strenuous activity will help you remain protected from injuries resulting due to sudden stress and strain.

Summary:

Changing your lifestyle and taking a few preventive measures in everyday activities can go a long way in preventing risk factors for bursitis. Simple things like changing your sitting habits and posture, not over stressing and putting on too much wait can go on a long way in keeping you away from this disease.

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