Bursae are small sacs filled with synovial fluid that occur in the body where there is much friction. The sacs absorb friction. If the friction is too large, the overuse injury bursitis can occur. Bursitis is an inflammation of the bursae. The most common sites of bursitis are the shoulder, the heel, the elbow, the knee, and the area around the hip. Bursitis is a typical overuse injury. The prognosis of bursitis is good. Although the pain can be severe it disappears within a few weeks.
What are causes of bursitis?
Bursae occur in the body where there is much friction. Bursae are a sort of sacs that reduce friction and absorb shocks. When in a short time the friction and, or impact on the bursa is high, the bursae may become inflamed and a bursitis will develop. For example, when suddenly a lot of work is with the shoulders is performed, a bursitis in the shoulder can occur. Bursitis can also occur when suddenly the pressure on the bursa is high, for example by a fall. An acute bursitis often occurs shortly after the triggering activity. For example, after a day of kneeling on a wooden floor, the patient develops a bursitis prepatellaris. Bacteria can also be a cause bursitis.
What are symptoms of bursitis?
A bursitis is usually caused by overuse of the bursae. Common sites of bursitis in the body are the shoulder (bursitis acromialis), elbow (bursitis olecrani), heel (achillobursitis), knee (bursitis prepatellaris) and hip (trochanteric bursitis). A bursitis in the shoulder is more common in people who eg overhead work and overhand athletes. A bursitis around the knee is common in people who are working on their knees (carpet layers, pavers). There is a marked inflammatory respons in a bursitis. Clear signs of inflammation are pain (dolor), swelling (tumor), redness (rubor), heat (dalor) and loss of function (functional lesion). These signs are also seen in a bursitis. Sometimes the pain can be severe. The patient supports the arm when there is a bursitis in the shoulder any movement of the arm is extremely painful. The practitioner cannot perform physical examination when the patient has extreme pain. However the extreme pain may be an indication for a bursitis. When the patient has a bacterial bursitis, the patient may have a fever.
What is the treatment of bursitis?
The prognosis of bursitis is usually good. Although the pain can be very severe, the pain disappears within a few weeks. Rest is the most important in the treatment of bursitis. When a bacterial bursitis is present, antibiotics may be prescribed. Paracetamol can be used against the pain. Also ice on the painful area may reduce pain. If after several weeks symptoms are not disappeared, sucks the bursae. Then the bursae will be injected with corticosteroids. Corticosteroids inhibit the inflammatory response. When a bacterial bursitis is present the bursae is emptied after a cut in the bursa is made. If bacteria are the cause, the bursae swells by pus. The pus is removed from the bursae. When a chronic bursitis occurs, the bursae can be removed by surgery in some cases. The bursae is however almost never removed.