Bursitis

Bursitis is a painful condition that affects millions of people worldwide, often caused by repetitive movements or prolonged pressure on a specific joint. It’s commonly associated with physically demanding activities, sports, or occupations that involve repetitive motions. However, it can affect anyone, regardless of lifestyle. Understanding bursitis, including its causes, symptoms, prevention methods, and treatment options, is crucial for maintaining joint health and overall well-being.

What is Bursitis?

It is the inflammation of a bursa, a small fluid-filled sac located near joints. Bursae act as cushions between bones and surrounding soft tissues, such as muscles, tendons, and skin, to reduce friction and provide smooth movement. When a bursa becomes inflamed, the cushion loses effectiveness, causing pain and limiting movement. It commonly occurs in major joints, such as the shoulder, elbow, hip, and knee, but it can also affect other areas, like the ankle and heel.

It can affect various areas of the body, and the types of bursitis are usually named after the joint or area they impact:

1. Shoulder (Subacromial Bursitis):
   Often a result of overuse, shoulder bursitis is common in athletes and individuals who perform repetitive overhead activities, such as painters and construction workers.
2. Elbow (Olecranon Bursitis):
   Elbow bursitis typically arises from leaning on hard surfaces for long periods or repeated elbow movements, common in professions such as carpentry and plumbing.
3. Hip (Trochanteric Bursitis):
   Affecting the outside of the hip, this type is common among runners and individuals with poor posture or one leg shorter than the other.
4. Knee (Prepatellar Bursitis):
   Also known as “housemaid’s knee,” this form occurs due to prolonged kneeling or frequent bending of the knee, commonly seen in individuals who work on their knees, such as gardeners and carpet layers.
5. Ankle and Heel Bursitis:
   Inflammation in these areas often arises from wearing improper footwear, repetitive movements in sports like running or jumping, or conditions such as plantar fasciitis.

Causes and Risk Factors

Several factors contribute to the development of bursitis:

1. Repetitive Motion:
   Repetitive movements, such as bending, lifting, or twisting, can increase the risk of bursitis. For example, athletes who throw, run, or jump frequently are more prone to bursitis.
2. Prolonged Pressure on Joints:
   Keeping pressure on a joint for an extended period, like kneeling on hard surfaces, can irritate bursae and lead to inflammation.
3. Injury or Trauma:
   Direct trauma or a sudden injury to a joint can cause bursitis by triggering inflammation in the bursa.
4. Age-Related Wear and Tear:
   With aging, the body’s tissues, including bursae, become less resilient and more prone to inflammation.
5. Underlying Health Conditions:
   Conditions such as rheumatoid arthritis, gout, and diabetes can increase susceptibility to bursitis. Rheumatoid arthritis, for example, involves an inflammatory process that can spread to bursae.
6. Poor Posture or Biomechanics:
   Poor posture, muscle imbalances, and structural irregularities can place undue stress on certain joints, increasing the likelihood of bursitis.

Bursitis symptoms

Symptoms vary depending on the location and severity but commonly include:

• Localized Pain and Tenderness:
  Pain around the affected joint, particularly when moving or pressing on the area, is a hallmark of bursitis. The pain may be sharp or a dull ache.
• Swelling and Warmth:
  The area around the inflamed bursa may be swollen, warm to the touch, and, in some cases, visibly red.
• Limited Range of Motion:
  Pain and inflammation can restrict movement, making everyday activities difficult and uncomfortable.
• Stiffness in the Joint:
  Stiffness, especially after prolonged inactivity, is another common symptom. Stiffness and limited mobility are particularly noticeable in morning hours or after rest.

Diagnosis

When experiencing joint pain, particularly if it persists or worsens, it’s important to see a healthcare provider. Diagnosis of the condition typically includes:

1. Medical History and Physical Examination:
   The healthcare provider will ask about symptoms, recent activities, and any possible injuries to assess the likelihood of bursitis.
2. Imaging Tests:
   X-rays, ultrasounds, or MRI scans may be used to confirm bursitis and rule out other joint issues such as arthritis, fractures, or tendon injuries.
3. Aspiration or Fluid Analysis:
   In cases where infection is suspected, the doctor may aspirate fluid from the bursa with a needle. This sample is analyzed for signs of infection or crystal deposits indicative of gout.

Prevention

Prevention involves taking measures to reduce joint stress and avoid repetitive strain:

1. Practice Good Posture:
   Maintaining proper posture during activities can reduce unnecessary strain on joints. Ergonomic adjustments at work, such as using supportive chairs and adjusting computer monitors, can help prevent bursitis.
2. Take Breaks and Avoid Repetitive Motions:
   Regular breaks, particularly in occupations involving repetitive movements, can reduce strain. Stretching and changing positions frequently can also be beneficial.
3. Strengthen Muscles and Improve Flexibility:
   Strengthening the muscles around joints, particularly through low-impact exercises like swimming and cycling, can improve joint stability and reduce stress on bursae.
4. Use Proper Equipment and Protective Gear:
   Wearing cushioned knee pads, supportive footwear, or wrist braces during activities that place pressure on joints can prevent bursitis. Choosing shoes that provide adequate arch support is essential for joint alignment.
5. Warm Up Before Physical Activity:
   Warming up and stretching before exercise or heavy physical work can reduce the risk of bursitis by preparing muscles and joints for the task ahead.

Bursitis treatment

Once diagnosed, treatment options depend on the severity and location of the condition:

1. Rest and Activity Modification:
   Reducing activity levels and allowing the affected joint to rest is the first step. Avoiding movements that worsen the pain is essential.
2. Ice and Heat Therapy:
   Applying ice packs for 15–20 minutes several times a day can help reduce inflammation and numb the pain. Heat therapy can improve blood flow and alleviate stiffness once initial inflammation subsides.
3. Medication:
   Over-the-counter anti-inflammatory drugs (NSAIDs) like ibuprofen or aspirin can relieve pain and inflammation. In cases of severe pain, a doctor may recommend corticosteroid injections directly into the affected bursa.
4. Physical Therapy:
   Physical therapists can help patients learn exercises that increase strength, flexibility, and range of motion, which can reduce strain on the bursa.
5. Aspiration:
   If fluid buildup is significant or infection is suspected, a doctor may aspirate the fluid with a needle to relieve pressure.
6. Surgery (in Rare Cases):
   In cases where bursitis is chronic or fails to respond to conservative treatments, surgical intervention may be considered. The procedure, known as a bursectomy, involves removing the inflamed bursa.

Complications

Ignoring bursitis can lead to complications, particularly if it becomes chronic. Chronic bursitis can lead to:

• Permanent Joint Damage:
  Long-term inflammation can harm the joint’s surrounding tissues, leading to reduced mobility and potential deformity.
• Infection (Septic Bursitis):
  In cases of infected bursitis, known as septic bursitis, the infection can spread, causing serious health issues if not treated with antibiotics or, in some cases, surgical drainage.
• Reduced Range of Motion:
  Chronic bursitis can lead to scar tissue formation, which can restrict movement and cause persistent stiffness and discomfort.

Living with Bursitis

For individuals with recurrent or chronic bursitis, lifestyle adjustments and ongoing management can make a significant difference in maintaining a high quality of life:

1. Regular Exercise and Stretching:
   Gentle exercises that strengthen and stretch surrounding muscles can improve joint function and reduce the frequency of flare-ups.
2. Avoiding High-Impact Activities:
   Avoiding high-impact exercises, such as running on hard surfaces, can reduce joint stress. Instead, opt for low-impact activities like swimming, cycling, and yoga.
3. Monitoring Symptoms and Seeking Early Intervention:
   Recognizing the early signs of bursitis and addressing them promptly can prevent progression. Regular visits to a healthcare provider can help monitor joint health.
4. Anti-Inflammatory Diet:
   Incorporating anti-inflammatory foods, such as omega-3-rich fish, leafy greens, and berries, can help reduce inflammation throughout the body.

Bursitis is a common yet manageable condition affecting individuals across all age groups and activity levels. By understanding the risk factors, symptoms, prevention strategies, and treatment options, individuals can effectively reduce the impact of bursitis on their lives. Whether it’s making lifestyle changes, practicing good posture, or engaging in physical therapy, proactive measures play a vital role in preventing and managing the condition, allowing individuals to enjoy healthier, pain-free movement.

Additional Reading:

• https://www.hopkinsmedicine.org/health/conditions-and-diseases/bursitis
• https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242
• https://my.clevelandclinic.org/health/diseases/10918-bursitis