What is Bursitis?
The bursa, a sac of lubricating fluid that is “located between tissues such as bone, muscle, tendons, and skin”, is responsible for decreasing friction, rubbing and irritation. The condition of bursitis occurs when the bursa is inflamed or irritated. It is caused by serious injury or a “repetitive, minor impact on the area”, and age is a factor. As the tendons age, they cannot handle stress, they are easier to tear, and they are not as elastic. Overuse is also an issue. Some of the high-risk activities that can lead to this condition include tennis, golf, painting, scrubbing, carpentry, shoveling, gardening, raking, throwing, pitching, and skiing. Poor posture, and lack of stretching before exercises, can also trigger this condition. The bursa sac may also be stressed by arthritis or leg length differences, as well as gout, thyroid disorders, or medication reactions. A bursa can also become inflamed by an infection. Bursitis is most commonly found in people over the age of 40. It commonly affects the hip, shoulder, elbow, knee, and Achilles tendon.1
Symptoms and Types of Bursitis
Pain is the typical symptom of this condition, and the pain can either be sudden or it may gradually build up. Severe pain is more likely “if calcium deposits are present”. Some patients develop frozen shoulder (adhesive capsulitis), which is a loss of shoulder motion, as a result of the pain and immobility of shoulder bursitis.2 Hip bursitis is another type, and patients can also get this condition, as mentioned before, in the elbow and knee as well as the base of the big toe and heel. Basically, it affects joints that have frequent and repetitive motion. The pain can go away after weeks of treatment, but “recurrent flare-ups” are common. Patients might feel stiff or achy, and there could be more pain if the joint is moved or pressed. The joint might appear red and swollen. A doctor should be contacted if the joint pain is disabling or lasts for weeks, if the redness and swelling are excessive, if there is a rash or bruising, if the pain is shooting or sharp, and if the patient has a fever.3 Trochanteric bursitis is a “painful inflammation of the bursa located just superficial to the greater trochanter of the femur”. Falls, running, and lateral hip surgery are associated with this condition. Patients have hip pain (even though this bursitis is not in the hip joint) which can radiate down the thigh.4 Another name for the trochanteric type is hip bursitis.5 It does not always take a big injury to create a problem For example, “lifting a bag of groceries” could “lead to shoulder bursitis”. Infection from a knee scrape or gout crystals can also bring on this disorder.6 Elbow bursitis may be caused by trauma, or a “hard blow to the tip of the elbow”, as well as prolonged pressure, such as leaning on the elbow on hard surfaces over a long period of time. Sometimes infection from a scrape or insect bite can bring on bursa swelling with fluid or pus. Of course gout and rheumatoid arthritis are also associated with this type of condition.7
Bursitis Treatment Options
Standard medical treatments for this condition are “rest, ice, and taking a pain reliever”, and possibly antibiotics if an infection is involved, or physical therapy exercises. Some patients may be prescribed corticosteroid injections, while others might need a cane or other assistive device. If necessary, patients may require having a bursa “surgically drained”, but it is rare to need one removed. There are some home treatment options, as well, including RICE (as noted before), avoiding elbow pressure, and using a pillow between the legs if sleeping on one’s side. Prevention is helpful. Kneeling pads, proper lifting, wheeling heavier loads, taking breaks, walking around, keeping a healthy weight, exercising, and warm up stretches are all beneficial.8 Aside from medical options and home treatments, chiropractors can help alleviate pain by using spinal manipulations to decrease inflammation and promote natural healing. Chiropractic care may also include manual therapy (trigger point therapy, massage), stretching, orthotics, taping, ultrasound, electrical stimulation, and nutritional advice.9 Massage therapy is another alternative treatment that can alleviate the pain of this disorder. Myofascial release therapy is used to apply “pressure that releases or loosens tightness in your fascia, the protective layer which surrounds your bones, muscles and joints”. Some of the massage treatments include Swedish massage (to decrease stress hormones and muscle toxins and promote relaxation and circulation), deep tissue massage (to release tension in the deepest layers of the fascia, tendons, and muscles), and the use of hot stones (to reduce pain, spasms, and tension and improve blood flow). By using chiropractic and massage to treat the underlying condition, patients can try to avoid the side effects of medications and risks of surgery.10
Learn more about bursitis treatments.