Bursitis - Causes, Symptoms and Treatment

Bursitis is inflammation of the fluid-filled sac that lies between a tendon and skin, or between a tendon and bone. The condition may be acute or chronic . Bursitis is commonly caused by repetition of movement or excessive pressure. Elbows and knees are the most commonly affected because they are rested upon more than many parts of the body with bursae and they also get the most repetitive use Bursitis, tendinitis, and other soft tissue diseases such as myofascial syndrome, are rheumatic diseases that affect the tissues and structures that surround a joint and produce pain, swelling or inflammation. Bursae are found throughout the body but the most important to you are those in the shoulder, elbow, knee, and hip.

In bursitis, a bursa becomes inflamed, sometimes as a result of gout. By far the most common causee, however, is excessive or improper use of the joint. Most often affected are the bursae deep in the shoulder, but almost any bursa in any joint in the body may become inflamed. Some of these inflammatory conditions have earned special names such as "housemaid's knee" and "tailor's bottom."

Bursitis is the inflammation of a bursa. Problem arises when a bursa becomes inflamed. The bursa loses its gliding capabilities, and becomes more and more irritated when it is moved. Movement of an inflamed bursa is painful and irritating Bursae are flattened sacs that serve as a protective buffer between bones and overlapping muscles or between bones and tendons/skin. Bursitis produces great pain when any effort is made to move the joint.

Bursitis most commonly affects the subacromial, olecranon, trochanteric, prepatellar, and infrapatellar bursae. Bursae are lined with special cells called synovial cells, which secrete a fluid rich in collagen and proteins. This synovial fluid acts as a lubricant when parts of the body move. When this fluid becomes infected by bacteria or irritated because of too much movement, the painful condition known as bursitis results. There are 160 bursae in the body. The major bursae are located adjacent to the tendons near the large joints, such as the shoulders, elbows, hips, and knees.

Cause of Buritis

• Occasionally from an infection
• Abnormal joint position
• Bursitis usually results from a repetitive movement or due to prolonged and excessive pressure.
• Another cause of bursitis is a traumatic injury
• The bursa, which had functioned normally up until that point, now begins to develop inflammation, and bursitis results.
• Systemic inflammatory conditions, such as rheumatoid arthritis , may also lead to bursitis. These types of conditions can make patients susceptible to developing bursitis.
• Septic bursitis occurs from direct introduction of microorganisms through traumatic injury or through contiguous spread from cellulitis (50-70% of cases).
• Peribursal cellulitis
• Fever
• The swelling itself causes irritation because the sac will no longer fit in the small area between the two objects and so the bone begins to pressure it and bursitis ensues.
• Bursitis can be caused by chronic overuse, trauma, rheumatoid arthritis , gout ,.

Symptoms of Buritis

Symptoms of Buritis :

• Symptoms can vary from an ache and stiffness in the local area of the joint, to a burning that surrounds the whole joint around the inflamed bursa.
• Symptoms of bursitis may include localized tenderness of joint, edema, erythema, and/or reduced movement.
• Swelling and redness in affected areas .
• Limited movement in the affected areas

Treatment of Bursitis

Treatments may include:

• Physical therapy
• Occupational therapy
• Surgery
• Bursitis that is not infected can be treated with ice compresses, rest, and antiinflammatory and pain medications
• Noninfectious shoulder bursitis can also be treated with a cortisone injection into the swollen bursa
• Septic bursitis requires antibiotic therapy, sometimes intravenously. Repeated aspiration of the inflamed fluid may be required. Surgical drainage and removal of the infected bursa sac (bursectomy) may also be necessary
• Conservative treatment includes rest, cold and heat treatments, elevation, nonsteroidal anti-inflammatory drugs (NSAIDs), bursal aspiration, and intrabursal steroid injections
• Patients with suspected septic bursitis should be treated with antibiotics while awaiting culture results. Superficial septic bursitis can be treated with oral outpatient therapy. Those with systemic symptoms or who are immunocompromised may require admission for intravenous antibiotics. .