What Is Bursitis And How To Recognise It

Bursitis is an inflammation of the synovial fluid-filled sacs (bursae) that are located between moving structures. For example, bursae would sit between structures like tendon and bone, bone and skin, muscle and bone or ligament and bone. 

Sub-tendinous, subcutaneous and submuscular bursae act like a buffer system, creating a smooth, frictionless gliding surface to allow painless movement. Bursitis is quite common after a blunt trauma or repetitive low-level compressions which irritate the tissue and cause inflammation. Certain disorders like gout, rheumatoid arthritis and diabetes can also contribute to this condition.

What are the areas affected?

Elbows, knees, hips, and shoulders are usually affected with pain and/or with swollen joints.

Types

• Anterior Achilles tendon bursitis or Alberts disease is characterized by inflammation of the bursa. The bursa is located in front of the attachment of the tendon to the heel.
• Posterior Achilles tendon bursitis is located between the skin of the heel and the Achilles tendon. This type is common in young women and is usually the result of frequently walking in hardback shoes (heels).
• Trochanteric bursitis or hip bursitis is often the result of injury, overuse, spinal abnormalities, arthritis, or surgery. Hip bursitis is most common in women and middle-aged and older people.
• Elbow bursitis is caused by the inflammation of the olecranon bursa located between the skin and bones of the elbow. Elbow bursitis can be caused by injury or by applying constant pressure on the elbow (e.g. leaning on your office desk daily) . This is similar to the commonly known, ‘Tennis Elbow.’
• Pes Anserine bursitis refers to bursitis in the knee. The Pes Anserine bursa is located on the inside of the knee between the shin bone and the hamstring muscles. This can be caused by tight hamstring muscles, obesity, arthritis, or out-turning of the knee or lower leg.
• Kneecap bursitis or prepatellar bursitis is common in many tradesmen and women. It usually occurs as a result of repeatedly sitting on your knees as a plumber or carpet layer might do. 
• Septic bursitis occurs when a bursa becomes infected through a cut or insect bite. Any punctures to a bursa that allows harmful bacteria in will cause it to become inflamed. The bursa can also become infected via bacteria that is already in the body. This type of bursitis will need to be treated by a general practitioner before physiotherapy is conducted.

How is it diagnosed?

During a physical examination, bursitis is generally detected as a warm, tender swelling at the site of the bursae. At first we will conduct a physical exam and then an ultrasound exam can be done to confirm its presence and your City Physio Physiotherapist can refer you for a scan.

What are the symptoms?

The symptoms can vary from local joint pain, swelling and stiffness to burning, radiating pain that surrounds the joint. Pain is usually worse during and after activity or at night leading to stiffness the next day. It is often difficult to sleep on the affected side, especially if the bursae are inflamed in your hips or shoulder.

How is it treated?

Bursitis treatment depends on what caused it, but in most cases, it is triggered by overuse. Alleviating the symptoms with anti-inflammatory drugs, hot/cold packs and pain relief medication is important. Avoiding the repetitive activity along with postural correction and a good stretching program is necessary. Dry needling is also very beneficial in resolving this issue.

Need help?

If you are experiencing any of the symptoms mentioned, please contact the team at City Physiotherapy to book a consultation. Our friendly Physiotherapists can help to diagnose and treat any joint-related problems that you may encounter.

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