Bursitis describes inflammation in a specific bursa or bursae. A bursa is a structure within the body made up of a small enclosed fluid-filled sac found around muscles, ligaments tendons and bony prominences.
More than 150 bursae can be found within our body and their primary role is to allow smooth gliding of soft tissues such as muscles, ligaments and tendons over each other in an almost friction-free environment.
When a bursa becomes inflamed or irritated due to trauma, movements start getting limited and pain starts to set in. Initially, the condition presents itself through a vague discomfort which does not always cause sufficient limitation necessitating immediate action and attention.
If left unseen to, such problems tend to worsen generating more inflammation, causing more pain with further limitation of movement.
Often bursitis is treated with steroid injections. This intervention helps to remove the swelling, decrease the pain and allow one to return to function
The most common sites of bursitis are the shoulder, elbow, knee, hip and heel. This is specifically in those areas where bursae lie close to the skin. Bursitis often develops due to some form of mechanical malfunction within our body over a prolonged period of time, leading to a slow progressive onset of irritation of minor concern which eventually leads to inflammation, causing pain.
Typical signs and symptoms of bursitis consist of mild redness over the concerned bursa, along with stiffness in the specific joint the following morning. Significant swelling of the bursa may sometimes be present. This could be a sign of infection rather than just inflammation, in which case immediate medical attention must be sought.
When it comes to treating bursitis, it is very important to establish the presence or absence of inflammation and infection. Ice, rest and physiotherapy modalities, together with appropriately prescribed anti-inflammatory drugs, normally help in controlling the inflammatory bursae.
If a bursa is infected, this is usually treated by the medical practitioner using antibiotics. Physiotherapy is nonetheless important in both cases to decrease swelling and pain and to maintain specific joint motion.
More often than not, people are unaware of how they developed bursitis and although uncommon, it is possible for bursitis to develop spontaneously for no obvious reason. The presence of this condition in a significant number of hip, shoulder and knee problems is manifest and makes one believe that there is a mechanical component to the development of bursitis.
Taking the shoulder as an example, bursitis often develops just beneath the furthermost bony tip of our shoulder, known as the acromion, describing a condition referred to as subacromial bursitis.
Such a condition usually develops due to a decreased space in the area which may result from swelling, arthritis or even bad posture. This point needs special emphasis because posture analysis and screening of one’s body mechanics is an important consideration that has to be taken seriously to help avoid problems such as the one being described.
Repetitive movements, such as those required by strenuous manual jobs, also predispose to development of shoulder subacromial bursitis which, if taken for granted as a mild shoulder problem simply treated with mild pain killers, will most certainly recur in the form of problems that are potentially more serious.
The emphasis must be on a clear understanding of the problem and addressing it properly with appropriate care. Posture screening and, in this case, shoulder stabilisation exercises will help.
Often bursitis is treated with steroid injections. This intervention helps to remove the swelling, decrease the pain and allow one to return to function.
In severe cases that resist most treatment modalities surgery is considered. This means the bursa is surgically removed thus eliminating the cause of the problem which also means eliminating a component that is important for the mechanical functioning of our body.
This article is intended to inform the reader that noticing the symptoms early and taking prompt action to solve the problem with the help of conservative treatment could possibly avoid the need for interventions in the form of steroid infiltration or surgery.
pacejosef@gmail.com
Josef Pace is a physiotherapist.