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Health Tip: Bursitis, not just a geriatric problem
Many people have heard of bursitis, but few know what a bursa (the structure that
is affected in bursitis), actually is. In the body there are over 150 bursae (the
plural of bursa). A bursa is a small jelly-like sac, which serves as a cushion to
decrease pressure between two adjacent structures. As an example, when a tendon slides against a bone in the process of moving a joint,
a bursa helps to decreases the friction between these two structures. If a bursa
becomes inflamed, a painful condition known as bursitis develops. With bursitis,
joint motion becomes restricted or painful.
Let's look at how bursitis develops and at some of the most common types of bursitis.
What causes bursitis? Most commonly, bursitis develops as a result of overuse, or
because of a traumatic injury. Repetitive movements, such as throwing a ball, scrubbing
a floor, or running, are example of activities that can produce overuse injuries.
Trauma, such as a contusion, can also lead to the development of swelling and inflammation
within the bursa sac.
Which bursae are most commonly affected? Fortunately, only
a few of the bursae in the body are likely to become inflamed. These include the
bursa at the side of the hip joint (trochanteric bursa), one on top of the shoulder
(subacromial bursae), a bursa on the front of the kneecap (pre-patellar bursa) and
the bursa at the tip of the elbow (olecranon bursa).
- Trochanteric bursitis is a
common problem that causes pain over the outside of the upper thigh. The trochanteric
bursa rests between the bony prominence on the side of the upper hip (the greater
trochanter) and a tendon that passes over this bone. Someone with trochanteric bursitis
usually reports having hip pain at night, particularly when lying on the affected
side. In trochanteric bursitis pain may also be noticed at the outside of the upper
hip when getting up from a chair or after prolonged walking, stair climbing, or
squatting.
-
Subacrominal bursitis affects the shoulder, causing pain with movement
such as reaching overhead or behind the back. It is part of a broader condition
known as "impingement syndrome". With impingement, "pinching" of the rotator cuff
tendons and bursa occurs between the humerus (upper arm bone) and the bony arch
(acromion) above. Impingement is one of the most common causes for chronic shoulder
pain. While it is more likely to develop in individuals over the age of 40, it is
far from a geriatric problem. Sports activities, including tennis, swimming, and
baseball, can all cause subacrominal bursitis. Work-related activities, such as
overhead assembly work, can also trigger this type of bursitis.
-
Pre-patellar bursitis
affects the bursa on the front of the knee cap (patella). This bursitis is sometimes
known as "housemaid's knee", since the repetitive pressure on the front of the knee
from kneeling, as when scrubbing a floor, is a typical cause. Prepatellar bursitis
can also be caused by a direct blow or fall on the knee. In prepatellar bursitis
a fluid filled lump is often visible over the front of the kneecap.
-
Olecranon bursitis
is associated with marked swelling at the tip of the elbow. Repeated pressure to
the tip of the elbow, as in someone who drives for long distances with their elbow
on an arm rest, is an example of the type of activity that can produce this type
of bursitis. A traumatic injury, such as striking the tip of the elbow in a fall,
can also cause olecranon bursitis.
What is the treatment for bursitis? While there
are some differences in treatment among the various types of bursitis, a few treatment
principles remain the same for all types. First a period of rest is necessary. This
means avoiding activities that led to the development of the bursitis or those that
aggravate the problem. Next, anti-inflammatory medications (e.g. Motrin, Aleve,
Naprosyn, etc.) are often recommended to help control the inflammation. Intermittent
application of ice to the skin overlying the inflamed bursa can also help to diminish
inflammation as well as serving to reduce pain. Other measures that are used
in treating bursitis include physical therapy, stretching exercises, cortisone injections,
and rarely surgery.
A special circumstance should be mentioned when treatment of
bursitis becomes urgent. If the skin overlying the bursa becomes broken, such as
with an insect bite or a scrape, bacteria may get inside the bursa and cause an
infection. Infected bursae can become markedly swollen with redness and swelling
of the overlying skin. Surgery, to incise the bursa and drain accumulated pus, along
with antibiotic treatment, is usually necessary.
So, if the doctor tells you that
you have bursitis, don't feel like you are necessarily "over the hill". Bursitis
is almost as common among younger, active individuals as it is in older folks.
If you have questions about bursitis please sign into your account and send us your questions. |
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