• Michael Liougas

Bursitis: The Villain Behind Joint Pain

Bursitis occurs when the small sacs of fluid cushioning bones, tendons and muscles become inflamed. These small sacs are called bursa, and they are prone to inflammation through repetitive motions or an injury. This condition is painful and often occurs around joints with the most wear, like shoulder joints, elbows, knees and hip joints.


image of joint with bursitis and without

While bursitis can happen to anyone, it is most common in people ages 40 and above as tendons wear down and become thinner and easier to tear. Problems with a bone or a joint put more pressure on a bursa, increasing a patient's likelihood of developing bursitis.


What causes bursitis?

Arthritis can lead to bursitis, as well as thyroid and inflammatory disorders. Overworking a joint is a dangerously easy way to develop bursitis, and activities like gardening, golfing, painting and shovelling can lead to bursitis through their repetitive joint use and the pressure such activities exert on joints and the areas surrounding them.


Even remaining motionless for too long can create enough pressure to inflame a bursa, especially when kneeling or putting constant weight onto elbows.


Swollen elbow bursitis


How do I know if I have bursitis?

Bursitis is found most commonly in the knees, shoulders, hips, buttocks, elbows, and heels. The first symptom where many notice bursitis is pain around their joints. A case of bursitis may be also be diagnosed as tennis elbow. Bursitis in the shoulder is similar to frozen shoulder, but they are in fact, two different conditions.


It may begin subtly, gradually increasing in intensity, or it can strike quickly and with eye-watering intensity. Exerting pressure by stretching and extending the joint will cause pain, and the joint's range of motion will be affected, sometimes without the presence of pain.


Other symptoms that occur alongside or independent of pain are redness around the joint, stiffness, and swelling. Fortunately, bursitis often mends itself through careful rest of the joint and by taking precautions in preventing further trauma to the joint. If this treatment is done properly, the pain surrounding the affected joint will often subside within one to two weeks.

shoulder bursae, elbow bursa, hip bursae and knee bursa

How to treat bursitis

Bursitis is a reoccurring condition that may return if the patient revisits the activities the caused their bursitis, and as such, those activities must be done less frequently to spare the sensitive bursa. Ice and elevation are also helpful in mending an inflamed bursa, as well as splinting the joint to alleviate pressure and to ensure a proper amount of immobility.


If symptoms and pain persist after a couple of weeks, a doctor may need to prescribe a steroid or antibacterial pill to reduce inflammation quickly, as well as pain levels. At Global Health Care Physiotherapy Clinic we would can help speed your recovery with in-clinic treatment.


shoulder injection of corticosteroid with ultrasound to guide injection is part of physiotherapy treatment

Clinical treatment for bursitis

Here is the shortlist of the clinical treatment you may need to treat bursitis:

  • Bursa is drained of excess fluid

  • Antibiotics

  • Non-steroidal anti-inflammatory drugs

  • Injections of Corticosteroid

  • Surgery (the bursa is removed completely, Iliotibial band release and tendon repair)

How to prevent bursitis

To prevent bursitis, there are simple steps one can take, like a 'stop if it hurts' ideology, having proper posture, and retaining a healthy weight. Other preventative measures include the use of cushions or pads when kneeling. For instance, you can use a pad below the knees when gardening.


Taking breaks from repetitive motions also helps to avoid bursitis. Staying relatively active throughout the day, and stretching before playing a sport or doing a workout.


Gradually building muscle strength before attempting a new workout or sport helps the area around the joint stay strong, preventing too much pressure from irritating the bursa sac.

hip bursitis
hip bursitis

Bursitis in the hips can be prevented by ensuring both legs are of the same length, an issue that can be mitigated by purchasing an orthotic shoe insert. Lifting correctly also deflects the potential of bursitis in the hips as proper, knee-bent lifting takes the pressure of the lifted load away from the hip joints.


It is difficult to avoid bursitis caused by an injury, but preventative measures can be taken to prevent the injury itself before it can lead to bursitis. One of the simplest, easiest preventative measures is stretching before a workout or before playing a sport.


Common areas prone to bursitis as a result of overuse in sports are the elbows and the buttock area. Golfers and tennis players experience bursitis in their elbows, hence the term tennis elbow, as a result of repetitive bending of the elbow. The bursa that sits lower in the hips can become inflamed after sitting somewhere hard for too long, like on an unforgiving bicycle seat.


Bursitis of the ankle can occur simply by wearing the wrong shoes, especially if one has an active, demanding job that requires much standing and walking. Though bursitis can be frustratingly easy to contract, it is equally as easy to prevent with proper care and preparation.


Resources

https://www.webmd.com/pain-management/arthritis-bursitis

https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242

https://www.niams.nih.gov/health-topics/bursitis

https://www.medicalnewstoday.com/articles/152120#causes


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