What is it?
Bursitis is inflammation of a bursa, a small fluid-filled sac that acts as a cushion between a bone and muscle, skin or tendon. The type of bursitis depends on the location of the affected bursa. This condition commonly affects the shoulder, elbow, hip, buttocks, knees and calf.
It often results from sports injuries or repetitive movements. But it can also be caused by:
- Bad posture, spine problems or walking habits
- Stress on soft tissues from an abnormal or poorly positioned joint or bone (such as leg length differences or joint deformities)
- Some types of arthritis and related conditions (rheumatoid arthritis, osteoarthritis and gout)
- Metabolic conditions such as diabetes
- Side effects from taking certain medications
Since the pain occurs near a joint, these conditions are sometimes mistaken for arthritis.
Risk factors for bursitis include repetitive motion, and overuse of a joint, certain occupations, and injury. Activities, such as gardening, involve repetitive motions which can cause it. Similarly, occupations like carpet laying and tile setting are also risk factors due to repetitive motion injury. Orthopaedic injuries, like an ankle sprain, can throw off body mechanics and cause bursitis of the knee or hip.
This condition causes inflammation, tenderness and pain in areas around a joint, such as the tendons, ligaments, bursae and muscles. Some conditions can occur suddenly, last for days or longer, and usually resolve with rest or treatment. They can also re-occur in the same body area.
A doctor can diagnose most soft tissue rheumatic conditions with a medical history and physical examination. If you experience persistent redness or swelling around the joints, as well as fever or chills, see a doctor immediately to make certain you don’t have an infection.
Bursitis may go away over time. If it doesn’t, the focus will be on reducing pain and inflammation, and preserving mobility to prevent disability and recurrence. A referral may be given to a rheumatologist, an orthopaedic surgeon, or a physical therapist for specialised treatment, if necessary. When properly treated, most of these conditions don’t result in permanent joint damage or disability.
Common bursitis treatment options include:
Rest and Splints
Many soft tissue conditions are caused by muscle overuse, so the first treatment may include resting the painful area, or avoiding a particular activity for a while. Splints, braces, or slings, allow a particular area to rest until the pain eases.
Hot and Cold Therapy
A cold compress can help reduce initial swelling and pain. Cold therapy is usually most effective during the first 48 hours after overuse, injury or swelling begins. After 48 hours, or for chronic (long-term) pain, dry or moist heat (e.g., warm bath), may be more helpful than cold compresses. Cold compresses however, is the preferred therapy by some therapists.
Over-the-Counter and Prescription Medicines
These medicines help relieve pain and/or inflammation. The doctor may recommend an over-the-counter analgesic (pain reliever), a nonsteroidal anti-inflammatory drug (NSAID), aspirin, ibuprofen or naproxen. Depending on the severity of the symptoms, doctors may prescribe a stronger version of an analgesic or NSAID.
Corticosteroids are powerful anti-inflammatory medicines. They are injected directly into a joint in a doctor’s office.
A physical therapist can provide the following:
- Hot/cold treatments, ultrasound (sound wave), laser and water therapy
- Soft tissue or joint mobilisation (manual therapy)
- A personalised exercise programme
- Education regarding appropriate activities to allow healing to occur
An occupational therapist can recommend modifications for daily activities and work habits to prevent re-injury. Hand and wrist splints can be created, and assistive devices suggested to help make daily activities easier.
A podiatrist can provide the following:
- Orthotics or pressure-relieving devices for the arms and legs
- Analysis of posture and walking
- Appropriate footwear
One of the best ways to take care of bursitis is to take a proactive role in your own treatment, a process called self-management. Because these conditions are mostly caused by overuse, the best way to prevent them from recurring is to avoid or modify activities that cause the problem. A doctor, physical therapist, podiatrist or occupational therapist can provide suggestions on modifying daily activities. Maintaining a healthy weight can also help take pressure off painful and swollen joints. Range-of-motion exercises can help as well to improve flexibility and reduce stiffness.
Your feet mirror your general health . . . cherish them!