Bursitis, also known as bursitis, is an inflammatory process of the bursa that is manifested by the typical signs of inflammation such as swelling, redness, hyperthermia and pain in the affected area.
What is bursitis?
The bursa is anatomically located exactly at the joints and supplies them with the necessary synovial fluid. An inflammation of the bursa occurs at predominantly at the knee joint. The anterior front of the kneecap is affected by the disease-typical impairments in bursitis. For this reason, bursitis is considered a classic disease of the knee joint. However, bursitis can also affect all joints, which in particular are exposed to sometimes enormous mechanical pressure. For this reason, bursitis can often also be diagnosed in the bursae of the joints of the elbow. In addition, bursitis of the shoulder joint may even be associated with damage to the tendons and ligaments.
Causes
The causes that can condition bursitis are relatively easy to classify. Basically, all impacts that can trigger bursitis cause the bursa in the joint to undergo inflammatory processes. This is because there may be excessive pressure on the area. These can contribute to bursitis either through falls or monotonous and prolonged unilateral movements of the joint. Constant sitting, endurance sports such as jogging or tennis, and specific occupational activities place severe pressure loads on the bursa. These can react to these permanent excessive stresses in the form of bursitis. Physiologically, as a result of these impacts, microfine injuries occur at the joints, which is the trigger for bursitis. In addition, accidents, osteoarthritis or arthritis are also the causes of bursitis at the affected joint area.
Symptoms, complaints and signs
Bursitis is usually a result of excessive stress on the shoulder. The pain often strikes the affected person completely unprepared. Often, the discomfort occurs at night and it becomes impossible for the patient to lie on the shoulder. Due to the gradual progression and the initially minor complaints, the bursitis is usually not taken seriously and is thus further aggravated. However, the pain can become so severe that a visit to the doctor becomes necessary. The inflamed joint is reddened and swollen. When touched, the affected area hurts. Due to increased blood flow to the surrounding tissue, the affected area feels heated. The inflamed joint is restricted in its movement. The severity of bursitis varies. If the symptoms are recognized early and taken seriously, the pain improves after a few days. In contrast, a protracted bursitis can take a chronic course and pain and restricted movement accompany the patient for months or years. If the cause is not overuse but an infection, fever and a general feeling of illness occur in addition to pain. Bursitis can occur in the shoulder, elbow, knee or hip. The symptomatology is identical in each case.
Disease process
Typical for bursitis is that only with advanced progression and constantly existing causes permanently noticeable complaints occur. Because of the different courses, chronic and acute bursitis are distinguished. Acute bursitis can develop into chronic bursitis if the condition is left untreated and the triggers continue to act. Depending on the affected joint, bursitis is initially accompanied by redness, increased warmth and swelling, accompanied by pain and more or less severe restrictions in mobility. Joint fluid collects in the bursa, which makes the skin around the joints in bursitis feel enlarged, flabby and doughy to the touch.After puncturing the bursa, a fluid comes out, which is called secretion, as it were, and resembles water in bursitis. If a strong mechanical action on the joint has led to bursitis, then this fluid is stained with blood.
Complications
In the worst cases, untreated bursitis can cause blood poisoning. However, usually there are no complications or only mild complications – inflammation and injury to the bursa, for example. The restriction of movement can occasionally lead to deformities. The inflammation can also spread to other regions of the body or even develop into a chronic disease. The usually severe pain generally represents a considerable physical and psychological burden for the person affected. If the disease persists for a longer period of time, the discomfort has a grueling effect and can subsequently also cause mental illness or aggravate existing ailments. Undesirable complications can also occur during treatment of bursitis. Surgery rarely causes discomfort such as bleeding, rebleeding, wound healing problems and scarring. Nerve, tendon, muscle and ligament injuries are also rare, but cannot be ruled out. In addition, allergic reactions to agents and materials used may occur. Immobilization can lead to medium-term muscle weakening and consequent restriction of joint movement. In addition, the risk of blood clots is somewhat increased. Prescribed medications may cause side effects and interactions and may cause allergic reactions.
When should you see a doctor?
If there is pain and redness in the bursa area, there may be bursitis. A visit to the doctor is recommended if the symptoms of inflammation become more severe and have not disappeared after three to four days at the latest. If other typical symptoms occur, such as signs of fever or restrictions in the ability to move the knee, it is best to consult a doctor directly. Risk groups include people with rheumatic diseases and patients with tuberculosis, gonorrhea or other infectious diseases. Those affected should inform the doctor in charge when the above-mentioned signs of the disease are noticed. The disease often occurs after an injury. If pathogens enter the tissue via a wound, inflammation and the above-mentioned symptoms occur. At the latest then a visit to the family doctor or an orthopedist is advisable. Further contacts are the internist or a sports physician. In the case of recurring complaints, further examination in a specialist clinic is advisable. Patients should also consult their doctor during treatment and inform him or her of any unusual complaints. Antibiotics, in particular, may cause further interactions and side effects that need to be clarified.
Treatment and therapy
In order to treat bursitis efficiently, conservative and surgical therapy are regularly advised in conventional medicine. Within the conservative treatments for bursitis, various medications in particular are used. These drugs are intended to alleviate both the inflammatory processes of bursitis itself and the bothersome symptoms. Cooling of the affected joint and temporary restriction of movement as well as effective pain medication, anti-rheumatic as well as anti-inflammatory drug substances support the therapy in case of bursitis. If the bursitis is caused by bacteria, antibiotics are administered. If the painful and inflammatory processes are contained to a certain degree, then physiotherapeutic or physiotherapeutic care can restore the mobility of the joint as a follow-up treatment for bursitis. In addition, ultrasound-assisted therapy is also considered effective. If the individual methods do not help, then as a last step, treatment of the bursitis can be done surgically. This is based on removal of the inflamed bursa under local anesthesia. For quick healing after the procedure, immobilization is performed with a fixation bandage or a bandage.
Prevention
Basically, bursitis can be prevented if, as it were, all movements or postures that stress the joint and overstress the joint are reduced. This applies mainly to strong pressure effects and such movements that take place under a constant action of forces that create friction in the joint. Expected hard falls should be prevented by appropriate protective elements to prevent bursitis.
Aftercare
In the worst case, untreated bursitis can cause blood poisoning. However, usually there are no or only mild complications – inflammation and injury to the bursa, for example. The restriction of movement can occasionally lead to deformities. The inflammation can also spread to other regions of the body or even develop into a chronic disease. The usually severe pain generally represents a considerable physical and psychological burden for the person affected. If the disease persists for a longer period of time, the discomfort has a grueling effect and can subsequently also cause mental illness or aggravate existing ailments. Undesirable complications can also occur during treatment of bursitis. Surgery rarely causes discomfort such as bleeding, rebleeding, wound healing problems and scarring. Nerve, tendon, muscle and ligament injuries are also rare, but cannot be ruled out. In addition, allergic reactions to agents and materials used may occur. Immobilization can lead to medium-term muscle weakening and consequent restriction of joint movement. In addition, the risk of blood clots is somewhat increased. Prescribed medications may cause side effects and interactions and may cause allergic reactions.
Here’s what you can do yourself
Throbbing pain, redness and swelling are the classic signs of bursitis, which can also be alleviated in its appearance in self-help. Going to the doctor is often not even necessary, for example, if an athlete has had several experiences with the condition and knows how to treat it. As with many other inflammatory conditions, cooling is a remedy that often works well to control the symptoms of bursitis. It is important that the ice is not applied directly to the affected area to rule out irritation of the skin. Ice cubes can be placed in a washcloth, for example, which is then applied if no ice is available in the form of a classic cold pack. Cooling should be done moderately anyway. If too much cold is applied, the tissue may react by increasing blood flow, which is rather counterproductive in the case of inflammation. Ice is therefore a suitable remedy in acute cases and for pain, but is not advisable for long-term use. Rest is also an important factor in bursitis. This means, for example, avoiding knee standing when inflammation has manifested in the knee. Heat exposure, such as hot baths, is also not advisable, at least in the acute stage. Athletes should wait until the inflammation has subsided before their next workout or competition.
