Introduction
Bursitis is an inflammation of a bursa caused by the repetitive use, trauma, infection or a systemic inflammatory disease.
A bursa is a tiny fluid-filled sac that functions as a gliding surface to reduce friction between tissues of the body. The major bursae are located adjacent to the tendons near the large joints, such as shoulders, hips and knees.
There are over 150 bursae in the human body. These small sacs lubricate and cushion the pressure points between a tendon and skin, or a tendon and a bone.
Bursitis normally affects the areas around joints in the shoulders, elbows and hips. Though less often, bursitis can also develop in the knee (washmaid’s knee), heel or even in the base of the big toe.
Types of Bursitis
The specific types of bursitis are associated to the location of the affected area. Here we list the various forms of bursitis, along with their locations:
1) Subacromial: Near the rotator cuff
2) Trochanteric: Over the bone of the side of the hip
3) Ischial: Below the bone in the buttock
4) Olecranon: At the tip of the elbow
5) Prepatellar: Beneath the skin and in front of the kneecap
6) Pes anserinus: Beneath the knee on the inner part of the leg
7) Retrocalcaneal: At the back of the heel
Calcaneal: At the sole or bottom of the heel
Causes of Bursitis
A bursa generally gets inflamed from injury, infection or an underlying rheumatic condition and in turn, loses its gliding capabilities. For instance, a simple act as lifting a heavy bag into the car can mark the onset of the condition.
Bursae are lined with synovial cells that secrete a fluid rich in collagen and proteins. This synovial fluid acts a lubricant and is infected by bacteria or is also irritated resulting into bursitis.
Here we list a few of the possible systematic causes of bursitis:
· Rheumatoid arthritis
· Bursa infection
· Scoliosis
· Gout
· Joint infection, injury or overuse
· Incorrect posture
· Stress on soft tissues
· Medications, such as celexa, lexapro and prozac
Diagnosis and Treatment
Bursitis is easily identified by a localized pain or swelling and tenderness and pain felt with the motion of the tissues in the affected area. X-ray testing can also reflect the calcification in the bursa, especially when the condition has been chronic or recurrent.
The treatment of bursitis in any form depends on whether the condition is infected (Septic bursitis) or non-infected (Aseptic bursitis).
Aseptic bursitis can be conveniently treated with one or more of the below measures:
· Ice compresses
· Anti-inflammatory and pain relieving medicines
· Aspiration of the bursa fluid with a syringe
· Cortisone injection
· Rest and general precautions
Septic bursitis requires further evaluation and treatment, beyond the above measures. The bursal fluid is often examined for the microbes causing the infection. One of the below measures are usually adopted in this case:
· Antibiotic therapy (oral/intravenous)
· Repeated aspiration of inflamed fluid
· Surgical drainage
· Surgical removal of infected bursa (bursectomy)
Though with proper treatment, bursitis normally cures itself within a week; recurrent flare-ups of bursitis are common and can be quite frustrating for both, the patient and the physician.
