Bursitis Overview
A bursa is a fluid-filled sac that cushions an area of friction between tissues, such as tendon and bone. Bursae reduce friction between moving parts of the body, such as around the joints of the shoulder, elbow, hip, knee, and adjacent to the Achilles tendon in the heel.
The number varies, but most people have about 160 bursae throughout the body. Bursae are lined with special cells, called synovial cells, which secrete a fluid rich in collagen and proteins. This synovial fluid acts as a lubricant when parts of the body move. Inflammation of a bursa is referred to as bursitis.
Bursitis Causes
The most common causes of bursitis are repetitive motions (for example, repeated throwing of a ball), trauma (extensive kneeling), infection, and preexisting rheumatoid conditions.
TraumaTrauma causes inflammatory bursitis from repetitive injury or direct impact.
Bursae close to the surface of the skin are the most likely to get infected with bacteria, a condition that is called septic bursitis. The most common bacteria to cause septic bursitis are Staphylococcus aureus or Staphylococcus epidermis. People with diabetes, alcoholism, certain kidney conditions, those with suppressed immune systems such as from cortisone medications (steroid treatments), and those with wounds to the skin over a bursa are at higher risk for septic bursitis. About 85% of septic bursitis occurs in men.
Rheumatoid conditionsPeople with certain diseases such as gout and pseudogout can develop bursitis from crystal deposits. When these crystals form in a bursa, they cause inflammation leading to bursitis.
Bursitis Symptoms and Signs
Bursitis causes pain and tenderness around the affected bone or tendon. The bursae sacs may swell, often making movement difficult. The most commonly affected joints are the shoulder, elbow, knee, and foot.
ShoulderIn the shoulder, the subacromial bursa (subdeltoid bursa) separates the supraspinatus tendon from the overlying bone and deltoid muscle. Inflammation of this bursa is usually a result of injury to surrounding structures, most commonly the rotator cuff. This limits the range of motion of the shoulder resulting in an "impingement syndrome." The condition causes pain in the side or front of the shoulder.
Bursitis of the tip of the elbow, olecranon bursitis, is the most common form of bursitis.
Retrocalcaneal bursitis occurs when the bursa under the Achilles tendon at the back of the heel becomes inflamed. This is commonly caused by local trauma associated with wearing a poorly designed shoe (often high heels) or prolonged walking. It can also occur with Achilles tendonitis.
Bursitis in this part of the body often occurs as an overuse injury in young athletes, ice skaters, and female adolescents transitioning to higher heels. The pain is usually on the back of the heel and increases with passive extension or resisted flexion.
ButtocksIschiogluteal bursitis causes inflammation of the ischial bursa, which lies between the bottom of the pelvic bone and the overlying gluteus maximus muscle (one side of the buttocks). Inflammation can come from sitting for a long time on a hard surface or from bicycling. Ischiogluteal bursitis has also been called weaver's bottom because it is common from the positioning used in this occupation.
The iliopsoas bursa is the largest in the body and lies in front of, and deep to, the hip joint. Bursitis here is usually associated with hip problems such as arthritis or injury (especially from running).
The trochanteric bursa, at the outer thigh over the hip, can become inflamed to cause trochanteric bursitis. Trochanteric bursitis is very common and occurs most frequently in overweight, middle-aged women.
When to Seek Medical Care
Because bursitis can be infectious and needs to be treated with antibiotics, it is best to see a doctor the first time you recognize symptoms.
If the pain is not getting better with home care, your doctor may be able to offer some alternatives such as a cortisone injection.
Fever is a definite sign to seek immediate medical care because it may signify infection. Heed other warning signs of infection such as constant warmth or redness around the joint or severe tenderness. Skin infections around the area (cellulitis) may mean that the bursa is infected as well.
Bursitis Diagnosis
Bursitis Treatment
The doctor will probably recommend home care with P-R-I-C-E-M: protection, rest, ice, compression, elevation, and medications (discussed below).
Bursitis Home Remedies
The treatment for bursitis can be remembered with the following memory device: P-R-I-C-E-M.
Medical Treatment
If your bursitis is not infectious, the doctor may inject the bursa with a corticosteroid to reduce inflammation.
If your bursitis is infectious, the bursa will be drained with a needle. The doctor will prescribe antibiotics to be taken in pill form. If the infection is very serious, does not respond to oral antibiotics, or if your immune system is weakened for another reason, you may be admitted to the hospital for IV antibiotics. Most causes of infectious bursitis, however, can be managed safely at home. Occasionally, a surgical operation to remove the bursa can be required.
Follow-up
After you leave the doctor's office, try to change whatever caused the bursitis in the first place. Wear different shoes. Use kneepads when kneeling for activities or work.
Rest the area and apply ice at least twice a day, keeping the area elevated when possible.
Schedule a follow-up visit with your doctor in one week. If your bursitis is infectious, a follow-up visit in three to four days is appropriate for reevaluation and possible fluid removal.
Bursitis Prevention
If a certain activity causes you to develop bursitis, then limit that activity or use protective measures. Use kneepads or cushioning for gardening and scrubbing floors. Workers such as plumbers, roofers, and carpet layers should wear knee protection. Choose more appropriate shoes or cushion the ankles with pads.
You can improve your flexibility and strengthen muscles involved in joint motion through rehabilitative exercise.
Be concerned about muscle tone if you have bursitis that tends to return. A physical rehabilitation program can guide you in the proper exercises to strengthen weak muscles.
Bursitis Symptoms and Signs
Bursitis causes pain and tenderness around the affected bone or tendon. The bursae sacs may swell, often making movement difficult. The most commonly affected joints are the shoulder, elbow, knee, and foot.
ShoulderIn the shoulder, the subacromial bursa (subdeltoid bursa) separates the supraspinatus tendon from the overlying bone and deltoid muscle. Inflammation of this bursa is usually a result of injury to surrounding structures, most commonly the rotator cuff. This limits the range of motion of the shoulder resulting in an "impingement syndrome." The condition causes pain in the side or front of the shoulder.
Bursitis of the tip of the elbow, olecranon bursitis, is the most common form of bursitis.
Retrocalcaneal bursitis occurs when the bursa under the Achilles tendon at the back of the heel becomes inflamed. This is commonly caused by local trauma associated with wearing a poorly designed shoe (often high heels) or prolonged walking. It can also occur with Achilles tendonitis.
Bursitis in this part of the body often occurs as an overuse injury in young athletes, ice skaters, and female adolescents transitioning to higher heels. The pain is usually on the back of the heel and increases with passive extension or resisted flexion.
ButtocksIschiogluteal bursitis causes inflammation of the ischial bursa, which lies between the bottom of the pelvic bone and the overlying gluteus maximus muscle (one side of the buttocks). Inflammation can come from sitting for a long time on a hard surface or from bicycling. Ischiogluteal bursitis has also been called weaver's bottom because it is common from the positioning used in this occupation.
The iliopsoas bursa is the largest in the body and lies in front of, and deep to, the hip joint. Bursitis here is usually associated with hip problems such as arthritis or injury (especially from running).
The trochanteric bursa, at the outer thigh over the hip, can become inflamed to cause trochanteric bursitis. Trochanteric bursitis is very common and occurs most frequently in overweight, middle-aged women.
When to Seek Medical Care
Because bursitis can be infectious and needs to be treated with antibiotics, it is best to see a doctor the first time you recognize symptoms.
If the pain is not getting better with home care, your doctor may be able to offer some alternatives such as a cortisone injection.
Fever is a definite sign to seek immediate medical care because it may signify infection. Heed other warning signs of infection such as constant warmth or redness around the joint or severe tenderness. Skin infections around the area (cellulitis) may mean that the bursa is infected as well.
Bursitis Diagnosis
Bursitis Treatment
The doctor will probably recommend home care with P-R-I-C-E-M: protection, rest, ice, compression, elevation, and medications (discussed below).
Bursitis Home Remedies
The treatment for bursitis can be remembered with the following memory device: P-R-I-C-E-M.
Medical Treatment
If your bursitis is not infectious, the doctor may inject the bursa with a corticosteroid to reduce inflammation.
If your bursitis is infectious, the bursa will be drained with a needle. The doctor will prescribe antibiotics to be taken in pill form. If the infection is very serious, does not respond to oral antibiotics, or if your immune system is weakened for another reason, you may be admitted to the hospital for IV antibiotics. Most causes of infectious bursitis, however, can be managed safely at home. Occasionally, a surgical operation to remove the bursa can be required.
Follow-up
After you leave the doctor's office, try to change whatever caused the bursitis in the first place. Wear different shoes. Use kneepads when kneeling for activities or work.
Rest the area and apply ice at least twice a day, keeping the area elevated when possible.
Schedule a follow-up visit with your doctor in one week. If your bursitis is infectious, a follow-up visit in three to four days is appropriate for reevaluation and possible fluid removal.
Bursitis Prevention
If a certain activity causes you to develop bursitis, then limit that activity or use protective measures. Use kneepads or cushioning for gardening and scrubbing floors. Workers such as plumbers, roofers, and carpet layers should wear knee protection. Choose more appropriate shoes or cushion the ankles with pads.
You can improve your flexibility and strengthen muscles involved in joint motion through rehabilitative exercise.
Be concerned about muscle tone if you have bursitis that tends to return. A physical rehabilitation program can guide you in the proper exercises to strengthen weak muscles.
Source: http://www.rxlist.com
Source: http://www.rxlist.com
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