Symptom, Causes and Diagnosis of Bursitis

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What is Bursitis?

Bursa is a small fluid-like sac that can be found throughout the body, located in areas where repetitive movements or pressure are constant. It acts like a cushion around bones and other tissues, and is lined with synovial cells that release a lubricating fluid to help reduce friction between moving parts. However, when inflamed or irritated, it can begin to swell, leading to pain, tenderness, and limited range of mobility, leading to a condition known as bursitis.

Types of Bursitis | Avant Orthopaedics

What are the Different Types of Bursitis?

When fluid builds up in the bursae located between the rotator cuff muscles and the acromion, it is described as shoulder bursitis. This is caused by constant overhead motions, and is prevalent in those who engage in activities such as painting and swimming (especially freestyle).

The bursa affected in this region is located at the olecranon, also known as the bony tip of the elbow. It is commonly linked to pressure being placed on the elbow for a prolonged time, such as when resting the elbow on a table or holding the plank position. It can also occur after a traumatic incident to the elbow.

Hip bursitis is caused by overuse or injury, leading to inflammation of either one or both of the two major bursae in the hip. These are the trochanteric bursa, located on the outside of the hip, and the iliopsoas bursa, located on the inside of the hip near the groin. It can be caused by repeated pressure on the hip, such as extended periods of standing and walking, as well as poor posture.

Knee bursitis is common among individuals who kneel for extended periods, such as carpet layers or gardeners. It is characterised by the inflammation of the bursa in the front of the patella (kneecap). This type of bursitis is commonly due to constant pressure being applied to the knees or a direct blow to the front of the knee.

Ankle bursitis is when one or more of the bursae located in the ankle becomes inflamed. This condition is associated with overuse, wearing ill-fitting shoes, or participating in activities that strain the Achilles tendon.

What are the Symptoms of Bursitis?

If you have bursitis, the sensation of pain can vary between being a dull ache and sharp or stabbing. In the initial stage, you may only experience pain when participating in activities that place stress on the affected area. As the condition progresses, you may experience discomfort even during rest or at nighttime, which can interfere with sleep and daily activities.

The swelling and inflammation of the bursa can cause stiffness and difficulty moving the affected joint. For example, if you have bursitis in your shoulder, you may find it challenging to reach overhead. This can also impact your overall mobility in cases of lower limb bursitis, which can cause walking, and getting in and out of a car, to be difficult.

Inflammation causes fluid to accumulate in the bursa. This leads to visible swelling in the affected area. It can also lead to pain if pressure is placed on the affected location. This symptom can also be accompanied by redness, where the skin will feel red and warm to the touch.

Bursitis of the Knee Joint | Avant Orthopaedics

What are the Common Causes of Bursitis?

Bursitis often develops due to repetitive motions or prolonged pressure on specific joints such as when participating in jobs or hobbies such as gardening and painting. If you place constant pressure on the bursae, they can become irritated and inflamed, which may in turn lead to swelling. Bursitis caused by this often develops gradually, with it often being easily overlooked in the early stages or attributed to other causes.

Poor posture can cause the development of bursitis as it puts added stress on some parts of the body. This can be seen in those who have jobs that require them to stand or sit for extended periods without proper ergonomics. Over time, this can lead to misalignment of the joints and increased pressure on the bursae, leading to bursitis.

Direct injury and trauma can cause the body’s inflammatory response to be triggered, leading to bursitis. However, unless it is a severe incident, resulting in fractures and dislocations, it is unlikely for you to have the condition from a single event.

If you have health conditions such as arthritis, and gout, then you may be at a higher risk of developing bursitis. They can cause inflammation in the joints, which can lead to irritation and swelling of the bursae.

Additionally, conditions that affect the body's ability to heal or fight infections, such as diabetes, may increase the possibility of developing infectious bursitis, a type of bursitis caused by bacterial infection

Bursitis is more common in older adults as the combined effect of wear and tear, ageing, and changes to joint structure can increase the risk of developing this condition. Those in a higher age group may also be more susceptible to conditions such as arthritis and diabetes, which can also add to the probability of developing bursitis.

How is Bursitis Diagnosed?

During a physical examination, your doctor will examine the affected area for redness, swelling, and warmth. They may also perform specific tests, depending on the location of the bursitis, to assess your range of mobility and identify other signs of discomfort.

An MRI scan provides detailed images of the soft tissues, including the bursae and surrounding structures. It can identify and help your doctor gauge the severity of inflammation, and fluid accumulation, along with other signs that may point to bursitis.

X-rays are used to rule out other possible causes of your symptoms such as fractures or dislocations. If no abnormalities are detected on the X-ray, it can support the diagnosis of bursitis.

Aspiration involves placing a needle into the bursa to drain some fluid. It is usually done if your doctor thinks you have an infection, along with helping distinguish between infective and non-infective bursitis. This fluid will be analysed to determine what the next course of treatment may be.

Are You or Your Loved Ones Suffering from Bursitis?

Running and walking are movements we perform in our everyday lives, and bursitis can turn them into a challenge. Contact us at Avant Orthopaedics for a personalised consultation and learn about the available treatments.

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