Bursitis

Bursitis is a severe health issue that needs to be treated properly. This guide 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 are not fixed kind. However, some characteristic features have been identified which could help you diagnose the disease.

The bursitis symptoms 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 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 and redness.

What are the results of Bursitis?

The most common thing resulting from Bursitis is pain. This pain can either build up gradually, or there can be a sharp or sudden rise in the pain if there are any calcium deposits.

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 challenging 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 some 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.

1. 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 body tissues during movement. Localized pain and tenderness can very well result from an inflamed bursa.

This can result in stiffness or localized swelling and is often accompanied by some warmth or the reddening of the affected area. In case there is inflammation, it becomes tough and painful to support the body’s pressure.

2. Hip Bursitis and Adhesive Capsulitis

For example, in the bursitis of the hip, which is among 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, which 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. This pain can either build up gradually, or there can be a sharp or sudden rise in the pain if there are any calcium deposits. 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 challenging 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 some 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.

Related: Reflexology

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 leading 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, 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. This, in turn, predisposes to bursitis. Such diseases are rheumatoid arthritis, gout, diabetes mellitus, psoriatic arthritis, and 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 a long way toward 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 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 due to subtle injuries such as the lifting of a grocery bag into the car.

Related: Morton’s Neuroma

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 patient’s side 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 worsen overnight if you sleep on your side. In that case, you should either sleep on your back or place a cushion between your knees.

You can treat bursitis in several ways; these usually include:

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

Related: Venous Insufficiency 

CorticoSteroids

If the condition hasn’t improved in 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. 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 of a patient has a frozen shoulder. The treatment uses a wide range of motion exercises and forearm or thumb splints and/or bands.

Surgery

If Bursitis hasn’t responded to any treatment taken, including steroids and prolonged use of physical therapy, then the 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. If there is a fluid stagnation or deposition of some crystals, those are usually removed during the surgery.

Alternative Treatment

Besides the regular forms of treatment using adequate rest and not resorting to the inflamed part to any physical activity or stress, there are some other forms of treatment also available for Bursitis.

If physical therapy and normal methods like the icing of the part have not responded well and redness or swelling is still experienced, then one may look for some other forms of treatment. Get ice pack ideas that are available on the market.

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

1. Aspiration

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

If the bursitis is non-infectious, then the treatment form 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.

2. Bursectomy and antibiotic-intravenous- injection

If the bursitis is septic, then it may require evaluation of 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 sometimes done intravenously.

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

Nonsteroidal anti-inflammatory drugs or NSAIDs in the form of ibuprofen can also be used for helping the inflammation and pain. Muscle atrophy can also be caused by bursitis; there is special exercise that needs to be done to increase mobility and build up strength again.

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:

1. Use of Kneeling Pads

If your occupation or hobby involves any activity where you have to kneel extensively, like for hours, you should use some padding to reduce the pressure on your knees.

2. Properly lifting

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

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

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

3. Walking around

Being lazy is never good for your health; now, it has been proved. 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.

4. Exercise

If the muscles are strong, then the chances of bursitis reduce.  Therefore, you must do regular exercise to build strength and maintain mobility. Increased strength will help protect the affected joints.

5. Maintaining a healthy weight

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

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

Conclusion

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 weight can go a long way in keeping you away from this disease.