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Breaking Through Bad Bursitis

Physical Therapy for Bursitis

Bursitis 101

Bursitis is a condition many are unfamiliar with until they begin to experience the telltale signs. Because bursae are located throughout the body, bursitis is not relegated to only one limb or joint but can occur in many different places. When pain is occurring near or around a joint, bursitis is one condition that should be included in the differential. Let’s take a deeper look at bursitis and how this condition can present in different parts of the body. 

SO MANY BURSAE…

Bursae (plural of bursa) are small fluid-filled sacs found near joints. Healthy bursae are very thin. They consist of a synovial outer membrane filled with slippery synovial fluid. These slippery sacs help the tendons, ligaments, muscles and skin glide smoothly over the bony surfaces of the joints. Though they contain only a small amount of fluid, they provide some cushioning to the area. These bursae play such an important role that there are actually more than 150 of them in the body. 

Bursae are located throughout the body. The major bursae commonly affected by bursitis are located near the joints of the shoulders, elbow, hips and knees, though technically bursae anywhere can become inflamed. Because of the bursae’s location beneath and between tendons, ligaments, muscles and skin, repeated movement over a bursa or prolonged pressure or positioning can result in inflammation of the bursa known as bursitis. As inflammation sets in, more synovial fluid is produced causing the normally thin sac to swell and take up even more space than they usually do. When this happens, many of the common symptoms of bursitis can develop.

Common symptoms of bursitis include pain and tenderness in the area of the inflamed bursa. It may be difficult to lie on the area of the body with bursitis due to the discomfort it causes. Joint mobility may be limited in the area around the inflamed bursa. If the bursa is located just below the surface of the skin you may even be able to visualize some redness and swelling in the area. Some people will experience repeated bouts of bursitis with resolution of symptoms in between.

AM I AT RISK FOR DEVELOPING BURSITIS?

Both lifestyle habits and the presence of certain medical conditions can put one at risk for developing bursitis. Let’s take a look at how some activities or lifestyle habits may affect certain bursa:

  1. Olecranon bursitis: The olecranon is the bony protuberance at the back of your elbow. Spend too much time leaning on your elbow on the desk while you work and you could inflame the bursa that lies just underneath the skin

  2. Trochanteric bursitis: The greater trochanter is located on the lateral side of the thigh near the hip. Running and frequent stair climbing may irritate the bursa at the greater trochanter where several muscles attach that move the hip and leg.

  3. Subacromial bursitis: The acromion is the front portion of your shoulder blade that protrudes across the top of your shoulder. Beneath the acromion and above the tendons that connect there lies the subacromial bursa that can become irritated and inflamed with repeated overhead motions such as throwing or reaching to stock high shelves.

  4. Infrapatellar bursitis: One of the bursa located beneath the patellar tendon of the knee where it attaches on your lower leg, the infrapatellar bursa may also experience bursitis. Also known as “clergyman’s” knee, this bursa can become inflamed as a result of direct trauma to the patella or kneecap, from frequent kneeling and even overuse.

Being diagnosed with certain medical conditions that can affect the joints may also put you at risk for developing bursitis. These conditions include osteoarthritis, diabetes, rheumatoid arthritis and gout. In some cases it may be difficult to tell whether pain is coming from the joint itself or the nearby bursa. 

Finally, septic bursitis is a less common but more serious cause of bursitis. In this case the bursa becomes infected by bacteria that has entered through a cut, scrape or abrasion on the skin. Rapid identification of this condition is important to allow for initiation of proper treatment.

WHAT ARE MY TREATMENT OPTIONS

Treatment of bursitis is typically conservative in nature. There are several treatment options, some which require the help of a physician. Let’s explore some common treatment options for bursitis.

Anti-inflammatories: Your doctor may recommend the use of anti-inflammatory medications to help calm the inflammation and reduce your pain. This may be prescribed in addition to other strategies like activity modification or the use of ice.

Corticosteroid injections: If you visit your doctor’s office for bursitis they may recommend that you undergo a corticosteroid and lidocaine injection into the affected bursa. This combination of medication can quickly reduce the inflammation and local pain.

Fluid aspiration: In some cases, when other options have failed, your physician may elect to aspirate the fluid that has built up in the bursa.

Physical therapy: Physical therapy is an important tool for treating bursitis. While the use of anti-inflammatories and corticosteroid injections can provide you with relief of your symptoms, it does not address the underlying cause of the bursitis thus placing you at elevated risk for developing future episodes.

With physical therapy, the goal is not only to address your immediate symptoms of pain and discomfort but to get to the root cause of the irritation on that bursa. Oftentimes optimizing flexibility and tissue mobility, muscle strength and coordination, motor control and balance along with some modifications to training or technique can provide long-term relief of symptoms.

Decreasing the pressure and irritation on the bursa while continuing to participate in the activities you need and love to do is physical therapy’s goal. So while you may be feeling discouraged from a bout or several bouts of bursitis, our team of skilled physical therapists at Evolve is here to help you onto the road to long-term symptom relief. 

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Brooklyn's Premier Holistic Physical Therapy Clinics- There’s physical therapy, there’s training, and then there’s EVOLVE. We use the science of biomechanics merged with fitness to help our patients get better and stay better! First we evaluate, then we heal, then we strengthen our clients so they can reach their goals, feel better, and live happier lives. We do so by utilizing a range of core techniques and specialized treatments to reduce pain, improve mobility, enhance physical strength and deal with the underlying issues, not just the pain itself.

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