What is Bursitis?

What are bursa?

Bursa are synovial fluid filled sacs that are approximately 4cm in diameter and 2mm thick.

Busa are located in many joints of the body such as the subacromial/subdeltoid bursa in the shoulders, olecranon bursa in the elbows, trochanteric bursa in the hip, prepatellar and infrapatellar bursa of the knee and the retrocalcaneal bursa in the ankle.

They aim to help the bones, tendons, ligaments and muscles in the joints to glide and move smoothly and decrease friction.

What is bursitis

Bursitis is inflammation and irritation of the bursa.

Symptoms include pain, tenderness, decreased joint range of motion. This can be particularly prominent on any compression of the bursa such as when laying on that side to sleep, overhead movements and more.

Bursitis can commonly occur with tendonitis of other muscles that attach to the site such the rotator cuff or gluteal muscles.

Bursitis can be diagnosed using ultrasound or MRI.

An acute bursitis can take anywhere from 4-6 weeks to heal if there is no re-injury or aggravation

Why does bursitis occur

Bursitis can occur as a result of a traumatic injury to an area or as a repetitive movement in activities such as carpentry, painting, gardening, shovelling and sports such as tennis, golf and baseball.

You are more likely to develop bursitis if you have conditions such as arthritis, gout, immune deficiencies such as HIV and diabetes, autoimmune conditions such as rheumatoid arthritis, scleroderma and lupus. Trauma and infection also predispose you to greater risk of bursitis.

How can you prevent bursitis?

As an athlete make sure you are warming up properly for 5 to 10 minutes prior to exercise and warming down properly after exercise and maintaining proper recovery strategies.

Use good equipment such as braces, shoes and pads to protect your joints.

Maintain a healthy lifestyle through exercise and diet by eating foods rich in vitamins, antioxidants, fibre, omega-3 and other anti-inflammatory foods. Avoid foods containing excess sugar and saturated fats.

What are the medical treatments for Bursitis

Medication that can be used for treatment includes nonsteroidal anti-inflammatory drugs (NSAIDS) to decrease acute pain, corticosteroid injections into the affected area and if the bursa is infected antibiotics.

Surgical treatment such as an arthroscopy in which the bursa will be drained and scar tissue removed.

What are some conservative treatments for Bursitis

Activity modification to avoid aggravating movements may be suggested. This can include overhead motions with the arms, running or laying on the side of bursitis of a hip, kneeling, bending and squatting for bursitis of the knee.

Exercise to strengthen the surrounding musculature as well as mobility to ensure that the joint and other compensatory mechanisms are working to the best of their ability may also be prescribed.

Some practitioners may choose to use ultrasound therapy or TENS machine for treatment however results are varied.

Seeing an Osteopath can also help with the symptoms of bursitis.

What will happen when you come to an osteopathic appointment?

When you come to an osteopathic appointment there are three stages of consultation. We will ask you about your injury, the mechanism of how you did it, what movements hurt, what makes it better. From there we will assess the area and test for impingement that may be caused by bursitis as well as other tests for the muscles and joints.

Through treatment we aim to decrease pain, increase range of motion and achieve specific patient set goals. Treatment can involve muscle energy techniques that focus on the muscle, joint mobilisation, fascial release, ligament release and more. After treatment we may prescribe exercises and refer you back to your doctor for scans if we think further investigation is required.

References:

What You Need to Know About Knee Bursitis – Well Heeled Podiatry. (n.d.). Retrieved June 27, 2024, from https://www.wellheeledpodiatry.com.au/what-you-need-to-know-about-knee-bursitis#:~:text=Activities%20like%20frequent%20kneeling%2C%20squatting%2C%20or%20bending%20the

Bennett, S., Macfarlane, C., & Vaughan, B. (2017). The Use of Osteopathic Manual Therapy and Rehabilitation for Subacromial Impingement Syndrome: A Case Report. EXPLORE, 13(5), 339–343. https://doi.org/10.1016/j.explore.2017.01.002

Bursa. (n.d.). Kenhub. https://www.kenhub.com/en/library/anatomy/bursa

‌bursa | Description, Types, & Function. (n.d.). Encyclopedia Britannica. https://www.britannica.com/science/bursa-anatomy

Chmielewski, R., Pena, N., Capalbo, G. (2013). Osteopathic manipulative treatment of pes anserine bursitis using the triple technique: a case report. AAOJ 23. Pp 34-38. https://www.researchgate.net/profile/Nicole-Pena-6/publication/287632071_Osteopathic_manipulative_treatment_of_pes_anserine_bursitis_using_the_triple_technique_A_case_report/links/5ff26ee5a6fdccdcb82a73d4/Osteopathic-manipulative-treatment-of-pes-anserine-bursitis-using-the-triple-technique-A-case-report.pdf?_sg%5B0%5D=started_experiment_milestone&origin=journalDetail&_rtd=e30%3D

Cleveland Clinic. (2020, May 29). Bursitis; Causes, Treatment & Prevention. Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/10918-bursitis

McCormack, J. (2023, October 10). Hip Bursitis Exercises To AVOID by a Physical Therapist. Flawless. https://flawlessphysio.co.uk/hip-bursitis-exercises-to-avoid/#:~:text=Walking%2C%20running%2C%20cycling%2C%20and%20many%20cardio%20exercise%20machines%2C

MSN. (n.d.). Www.msn.com. Retrieved June 27, 2024, from https://www.msn.com/en-us/health/condition/Bursitis/hp-Bursitis?source=conditioncdx

Sears, B. (2022, March 3). Bursae Are Small Structures That Protect Your Joints. Verywell Health. https://www.verywellhealth.com/bursae-anatomy-function-and-treatment-4686312