Bursitis
Encyclopedia
Bursitis is the inflammation
of one or more bursae
(small sacs) of synovial fluid
in the body. The bursae rest at the points where internal functionaries, such as muscle
s and tendon
s, slide across bone
. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying upon the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem.
and stiffness, to burning pain that surrounds the joint around the inflamed bursa. In this condition, the pain usually is worse during and after activity, and then the bursa and the surrounding joint become stiff the next day in the morning.
. Elbows and knee
s are the most commonly affected. Inflammation of the bursae might also be caused by other inflammatory conditions such as rheumatoid arthritis
. Although infrequent, scoliosis
might cause bursitis of the shoulders; however, shoulder bursitis is more commonly caused by overuse of the shoulder joint and related muscles.
Traumatic injury
is another cause of bursitis. The inflammation irritates because the bursa no longer fits in the original small area between the bone and the functionary muscle or tendon. When the bone increases pressure upon the bursa, bursitis results. Sometimes the reason is unknown. It can also be associated with some chronic systemic diseases.
, elevation, physiotherapy, anti-inflammatory drugs and pain medication. Since bursitis is caused by increased friction from the adjacent structures, a compression bandage
is contraindicated because compression would create more friction on movement (passive and active). Advanced massage
therapy techniques can also be employed to help with the inflammatory process of bursitis.
Bursae that are infected
requires further investigation and antibiotic
therapy. 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.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
of one or more bursae
Bursa (anatomy)
A bursa is a small fluid-filled sac lined by synovial membrane with an inner capillary layer of slimy fluid . It provides a cushion between bones and tendons and/or muscles around a joint. This helps to reduce friction between the bones and allows free movement...
(small sacs) of synovial fluid
Synovial fluid
Synovial fluid is a viscous, non-Newtonian fluid found in the cavities of synovial joints. With its yolk-like consistency , the principal role of synovial fluid is to reduce friction between the articular cartilage of synovial joints during movement.-Overview:The inner membrane of synovial joints...
in the body. The bursae rest at the points where internal functionaries, such as muscle
Muscle
Muscle is a contractile tissue of animals and is derived from the mesodermal layer of embryonic germ cells. Muscle cells contain contractile filaments that move past each other and change the size of the cell. They are classified as skeletal, cardiac, or smooth muscles. Their function is to...
s and tendon
Tendon
A tendon is a tough band of fibrous connective tissue that usually connects muscle to bone and is capable of withstanding tension. Tendons are similar to ligaments and fasciae as they are all made of collagen except that ligaments join one bone to another bone, and fasciae connect muscles to other...
s, slide across bone
Bone
Bones are rigid organs that constitute part of the endoskeleton of vertebrates. They support, and protect the various organs of the body, produce red and white blood cells and store minerals. Bone tissue is a type of dense connective tissue...
. Healthy bursae create a smooth, almost frictionless functional gliding surface making normal movement painless. When bursitis occurs, however, movement relying upon the inflamed bursa becomes difficult and painful. Moreover, movement of tendons and muscles over the inflamed bursa aggravates its inflammation, perpetuating the problem.
Signs and symptoms
Bursitis symptoms vary from local joint painPain
Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
and stiffness, to burning pain that surrounds the joint around the inflamed bursa. In this condition, the pain usually is worse during and after activity, and then the bursa and the surrounding joint become stiff the next day in the morning.
Cause
Bursitis is commonly caused by repetitive movement and excessive pressurePressure
Pressure is the force per unit area applied in a direction perpendicular to the surface of an object. Gauge pressure is the pressure relative to the local atmospheric or ambient pressure.- Definition :...
. Elbows and knee
Knee
The knee joint joins the thigh with the leg and consists of two articulations: one between the fibula and tibia, and one between the femur and patella. It is the largest joint in the human body and is very complicated. The knee is a mobile trocho-ginglymus , which permits flexion and extension as...
s are the most commonly affected. Inflammation of the bursae might also be caused by other inflammatory conditions such as rheumatoid arthritis
Rheumatoid arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks synovial joints. The process produces an inflammatory response of the synovium secondary to hyperplasia of synovial cells, excess synovial fluid, and the development...
. Although infrequent, scoliosis
Scoliosis
Scoliosis is a medical condition in which a person's spine is curved from side to side. Although it is a complex three-dimensional deformity, on an X-ray, viewed from the rear, the spine of an individual with scoliosis may look more like an "S" or a "C" than a straight line...
might cause bursitis of the shoulders; however, shoulder bursitis is more commonly caused by overuse of the shoulder joint and related muscles.
Traumatic injury
Injury
-By cause:*Traumatic injury, a body wound or shock produced by sudden physical injury, as from violence or accident*Other injuries from external physical causes, such as radiation injury, burn injury or frostbite*Injury from infection...
is another cause of bursitis. The inflammation irritates because the bursa no longer fits in the original small area between the bone and the functionary muscle or tendon. When the bone increases pressure upon the bursa, bursitis results. Sometimes the reason is unknown. It can also be associated with some chronic systemic diseases.
Examples
The most common examples of this condition:- Prepatellar bursitisPrepatellar bursitisPrepatellar bursitis, also known as Housemaid's knee, is a common cause of swelling and pain above the patella , and is due to inflammation of the prepatellar bursa. This structure is a superficial bursa with a thin synovial lining located between the skin and the patella...
, "housemaid's knee" - Infrapatellar bursitisInfrapatellar bursitisInfrapatellar bursitis is the inflammation of the infrapatellar bursa, which is located just below the kneecap. It is often called "clergyman's knee" due to its historical frequency amongst clergyman, who injured the bursa by kneeling on hard surfaces during prayer.It is a cause of knee pain....
, "clergyman's knee" - Trochanteric bursitis, giving hip pain
- Olecranon bursitisOlecranon bursitisOlecranon bursitis is a condition characterised by pain, swelling and inflammation of the olecranon bursa located in the elbow....
, "student's elbow", characterised by pain and swelling in the elbow - Subacromial bursitisSubacromial bursitisSubacromial bursitis is a condition caused by inflammation of the bursa that separates the superior surface of the supraspinatus tendon from the overlying coraco-acromial ligament, acromion, coracoid and from the deep surface of the deltoid muscle...
, giving shoulder pain
Treatment
Bursae that are not infected can be treated with rest, iceIce
Ice is water frozen into the solid state. Usually ice is the phase known as ice Ih, which is the most abundant of the varying solid phases on the Earth's surface. It can appear transparent or opaque bluish-white color, depending on the presence of impurities or air inclusions...
, elevation, physiotherapy, anti-inflammatory drugs and pain medication. Since bursitis is caused by increased friction from the adjacent structures, a compression bandage
Bandage
A bandage is a piece of material used either to support a medical device such as a dressing or splint, or on its own to provide support to the body; they can also be used to restrict a part of the body. During heavy bleeding or following a poisonous bite it is important to slow the flow of blood,...
is contraindicated because compression would create more friction on movement (passive and active). Advanced massage
Massage
Massage is the manipulation of superficial and deeper layers of muscle and connective tissue to enhance function, aid in the healing process, and promote relaxation and well-being. The word comes from the French massage "friction of kneading", or from Arabic massa meaning "to touch, feel or handle"...
therapy techniques can also be employed to help with the inflammatory process of bursitis.
Bursae that are infected
Infection
An infection is the colonization of a host organism by parasite species. Infecting parasites seek to use the host's resources to reproduce, often resulting in disease...
requires further investigation and antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
therapy. In cases when all conservative treatment fails, surgical therapy may be necessary. In a bursectomy
Bursectomy
A bursa is a small sac filled with synovial fluid that cushions adjacent structures and reduces friction. Bursectomy refers to the removal of one of these structures, usually due to chronic inflammation or infection....
the bursa is cut out either endoscopically or with open surgery
Surgery
Surgery is an ancient medical specialty that uses operative manual and instrumental techniques on a patient to investigate and/or treat a pathological condition such as disease or injury, or to help improve bodily function or appearance.An act of performing surgery may be called a surgical...
. The bursa grows back in place after a couple of weeks but without any inflammatory component.
External links
- American College of Rheumatology
- Bursitis treatment from NHS DirectNHS DirectNHS Direct is the health advice and information service provided by the National Health Service for residents and visitors in England, with advice offered 24 hours a day, every day of the year through telephone contact on the national 0845 46 47 number, web based symptom checkers at and via...
- General Bursitis Information at About.comAbout.comAbout.com is an online source for original information and advice. It is written in English, and is aimed primarily at North Americans. It is owned by The New York Times Company....
- Information from the Mayo ClinicMayo ClinicMayo Clinic is a not-for-profit medical practice and medical research group specializing in treating difficult patients . Patients are referred to Mayo Clinic from across the U.S. and the world, and it is known for innovative and effective treatments. Mayo Clinic is known for being at the top of...
- Bursitis information and treatment options from Bursitis.ws
- Bursitis Causes, Symptoms, Treatment, Types and Diagnosis from MedicineNet.com