Bursitis – what you need to know
Rosemary Marchese – Physiotherapist, Certified Schroth Physiotherapist for Scoliosis and Scheurmann’s
Bursitis is an inflammation or irritation of bursae (plural for bursa). Bursae are sacs of fluid found around joints or tendons. Bursae reduce the friction caused by movement and they also provide a cushion between bones, tendons, skin and muscle.
Why does bursitis happen?
Bursitis can happen suddenly as an acute bursitis or it can build up as a problem over time. Acute bursitis can occur as a result of trauma, e.g. falling and injuring the bursa, infection, or inflammatory condition. Repetitive motion or use can create a chronic bursitis.
What causes bursitis?
Common causes of bursitis include:
- Prolonged pressure, e.g. from kneeling, sitting or leaning on a joint for a long period of time
- Joint stress from altered or abnormal walking, e.g. walking unevenly due to a leg length discrepancy or back pain
- Overuse of a joint
- Some types of arthritis may aggravate the bursae in the joint, e.g. rheumatoid arthritis or psoriatic arthritis
- Injury, such as from a fall or other injury.
What are the symptoms of bursitis?
Common symptoms of bursitis are listed below:
- Pain or swelling at the affected joint. You can’t always see the swelling however. It is more common to see the swelling if the bursitis is occurring close to the skin, e.g. at the elbows, knee caps and heels. Sometimes you can actually find the location of the pain through touch.
- Pain with movement or stretching.
- Restricted movement, especially when there is significant swelling or pain restricting motion of nearby joints and muscles.
- If the bursitis is called by an infection, called ‘septic bursitis’, the symptoms may include pain, swelling, warmth, and redness of the affected joint. You may also experience fever. This is more serious than a typical bursitis and needs immediate medical attention as it can spready to nearby joints, bone or even blood.
- If the bursitis is caused by gout, this is not considered an infection, however the symptoms can mimic septic bursitis.
Treatment of bursitis
The aim of treatment is to focus on initially relieving pain and inflammation and treating any infection, if present. You also need to maintain range of motion and prevent any complications and stop it from occurring again! It’s ideal to find the source of the problem. If you have an underlying medical cause, such as infection, then you need to see your doctor straight away. However, if there is an underlying mechanical cause it’s ideal to see your physiotherapist to find out what is happening in your body to aggravate the bursa/e.
Protecting your joints can involve:
- Minimising or removing aggravating factors, at least temporarily.
- Padding or cushioning, e.g. trochanteric bursitis (at the hip) often causes pain in side lying so avoiding this or lying on a pillow can help take the pressure off the bursa.
- Modifying footwear
- Dealing with the causes, e.g. tight muscles, altered biomechanics.
In acute situations pain may be relieved by ice, especially in the superficial areas like the elbow, kneecap and heel. I often find patients respond well to heat for the hips, shoulder or inner (medial) knee.
If you have any further questions please call Max Sports Physiotherapy Clinic (02) 89140508.