What Is Bursitis
Bursitis is the inflammation of one or more bursae (small sacs) of synovial fluid in the body. They are lined with a synovial membrane that secretes a lubricating synovial fluid. There are more than 150 bursae in the human body. The bursae rest at the points where internal functionaries, such as muscles and tendons, slide across bone. Healthy bursae create a smooth, almost friction less functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying on the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem. Muscle can also be stiffened. Bursitis occurs most often at joints that perform frequent repetitive motion. There are more than 200,000 US cases per year.
Bursitis commonly affects superficial bursae. These include the subacromial, prepatellar, retrocalcaneal, and pes anserinus bursae of the shoulder, knee, heel and shin, elbows etc.
Symptoms vary:
Localized warmth and erythema
Joint pain and stiffness
Stinging pain that surrounds the joint around the inflamed bursa.
Pain usually is worse during and after activity, and then the bursa and the surrounding joint becomes stiff the next morning.
Bursae that are not infected can be treated symptomatically with rest, ice, elevation, physiotherapy, anti-inflammatory drugs and pain medication. Since bursitis is caused by increased friction from the adjacent structures, a compression bandage is not suggested because compression would create more friction around the joint. Chronic bursitis can be amenable to bursectomy and aspiration. Bursae that are infected require further investigation and antibiotic therapy. Steroid therapy may also be considered. In cases when all conservative treatment fails, surgical therapy may be necessary. In a bursectomy the bursa is cut out either endoscopically or with open surgery. The bursa grows back in place after a couple of weeks but without any inflammatory component.
