Bursitis – causes, complaints & therapy

Bursitis (bursitis)

Bursitis is a painful inflammatory reaction of the bursae mainly in the area of the elbow, knee, hip or shoulder joints. In medicine, a distinction is made between acute and chronic bursitis. The acute form of bursitis usually subsides within a few days with appropriate immobilization.

What is bursitis?

Bursitis can occur chronically or acutely, with the chronic course often resulting from infection or irreparable damage after injury.

However, an infection can reach the bursa via the bloodstream or through contact with a pathogen. An infection can be caused by tuberculosis or gonococci, for example.

Furthermore, bursitis can be caused by rheumatic diseases or autoimmune diseases.

The acute form of bursitis occurs much more frequently, because it is often the result of increased and excessive stress. For example, tilers often complain of pain in the kneecap or tennis players complain of pain in the shoulder.

Causes

The human body has cavities at different points with a corresponding buffer function. As a rule, these cavities cover prominent bone protrusions, such as the kneecap or shoulder joint. In addition, the cavities may be located between bony structures and tendons or they may be located between ligaments and bony structures.In all these cavities, bursitis, the so-called bursitis, can develop. Thus, heavy stress, infection or traumatic injuries can lead to inflammation of the structures.

The affected structure hurts greatly and the so-called synovial fluid increases sharply in the course of bursitis. This liquid consists mainly of water, proteins, glucose, hyaluronic acid and fat components and serves on the one hand for nutrition and on the other hand the shock absorber function of the joints. The accumulation of this liquid can be clearly felt as an effusion.

Symptoms and course

Possible symptoms:

  • Overheating of the joint

Due to the extent as well as the localization of bursitis, the symptoms can occur very differently. Initially, mild to moderate pain at the affected site is often complained of. Since the capsule of the bursa is equipped with sensitive nerve fibers and is very sensitive, a sharp pain occurs.

This pain is initially load-dependent and usually disappears with appropriate rest. In the further course, it can lead to severe and severe pain as well as movement restrictions under stress and rest.

In addition, swelling on the inflamed bursa can be felt very well. Often the swelling is accompanied by an elevated temperature in the corresponding pain area. These symptoms are important signs of acute bursitis.

When to the doctor?

In many cases, the bursitis heals spontaneously. This is also possible without a visit to the doctor and therapy by the doctor if the affected person consistently cools and protects the joint. Nevertheless, there are cases in which it makes sense to go to the doctor. This is especially the case when the pain and swelling do not subside after a reasonable period of time and actually tend to increase. The doctor can then, for example, sometimes hide another clinical picture behind the bursitis and its symptoms. An example of this is the meniscus injury in the knee joint, which can cause similar symptoms. A significant functional restriction in the joint is also a reason for going to the doctor, especially if it is permanent.

A complication that in any case makes a visit to the doctor necessary is blood poisoning. It can occur when the bursitis (bursitis) is caused by bacteria or other pathogens and the germs spread in the joint. Pain can be accompanied by fever and a general feeling of illness. The patient often recognizes reddening and overheating in the joint. Going to the doctor is important to prevent serious complications. These affect not only the function of the joint, but also the health of the patient in general.

Diagnosis

The doctor usually recognizes bursitis based on the classic symptoms. The patient complains of severe burning pain in the joint. Typically, the diseased region is intensively stressed by lifestyle. The discomfort becomes unbearable, especially when moving, which reduces the range of motion of the joint. When examining the affected joint, swelling can be seen in most cases, and the skin over this edema has become red and feels warm. This accumulation of fluid shifts on palpation. In severe cases, the inflammation spreads to neighboring lymph nodes, the swelling of which can be felt by the doctor. Then even fever can be added as a symptom.

However, these symptoms are not always clear. The orthopedist will therefore first take an X-ray . Any calcium deposits in the bursa (bursa) may be visible in the photo. With a sonography ( Ultrasound ), the doctor estimates the volume of liquid in the edema, occasionally a CT (computer tomography) is required to rule out malignant growths. In addition, the doctor often has to determine whether the bursitis is septic (inflammatory) or aseptic (non-inflammatory). This requires a puncture of the bursa. The laboratory can then detect or rule out microbial pathogens. With a blood test, the doctor distinguishes bursitis from rheumatic diseases.

Complications

In many cases, bursitis takes a complication-free course and often heals quickly with appropriate therapy. Nevertheless, there are some complications that can arise with this inflammatory disease. First of all, the transition from acute to chronic bursitis should be mentioned. This means that the disease can flare up again and again and becomes a burden for the patient due to the chronic course. can also develop on the basis of bursitis. This complication sometimes arises when bursitis is infectious and has not been adequately treated. Sepsis should then be treated promptly by the doctor in order to achieve a good course.

A complication sometimes arises after an operation. It is possible that the joint is functionally restricted after the operation. An infection during the operation cannot be ruled out either and is one of the classic risks of operations in the joint area. In addition, removing the bursa no longer protects it. The buffer effect that the bursa had is no longer available, so that arthrosis can also develop as a late consequence due to joint surfaces rubbing against each other. For this reason, as before any operation, the doctor must carefully weigh up the benefit-risk ratio for bursa surgery.

treatment and therapy

Basically, there are two different therapeutic approaches for the treatment of bursitis. On the one hand, this is a conservative therapy using pharmaceuticals and, if necessary, physiotherapy. On the other hand, the surgical intervention should be mentioned here, in which the inflamed bursa is removed.

The treatment of bursitis depends on the type and extent of the inflammation. Immobilization of the affected joint and appropriate cooling always come first in all therapeutic procedures.

Painkillers such as diclofenac or ibuprofen are also administered. If bursitis is caused by bacteria or an infection, an appropriate antibiotic can also be administered.

During an operation, the affected bursa is exposed under local anesthesia and then removed. The area is then provided with a drainage and closed and there is an immobilization for several days. The surgical as well as the conservative therapy have their advantages and disadvantages as well as different side effects.

Outlook and prognosis

Bursitis usually has a very good prognosis. This means that healing is often spontaneous and without complications. This also often happens when those affected simply resort to self-help and cool and protect the joint. This is common in athletes, where bursitis is more common and almost routine in tackling and team sports. Even laypeople can often reliably diagnose bursitis by palpation and take the necessary measures at an early stage, so that the bursitis has an excellent prognosis.

Bacteria are often the reason for a worsening of the prognosis. Because if the bursitis is caused by bacteria, the pathogens can spread and damage the joint. Blood poisoning is also one of the complications that can worsen the prognosis. Here it is important not to let the disease progress further by seeing a doctor early, by treating it quickly and adequately.

Surgery can also affect the prognosis. This can have potentially unfavorable effects in two ways. On the one hand, an operation in the joint area can have an infection as a side effect, which can then worsen the prognosis. On the other hand, after the bursa has been removed, the joint surfaces are in contact without the protection of the bursa’s buffering function and can more easily develop arthrosis.

Prevention

To prevent bursitis, it is important to avoid permanent and repetitive mechanical stress. Unilateral stress on the joints, as is often the case with sports (e.g. the shoulder-arm area in tennis), excessive kneeling work (laying tiles) or similarly stressful activities can cause bursitis.

Therefore, they should avoid long and persistent activities as much as possible and, if necessary, compensate for the stress with appropriate breaks and a change of the loaded joints (e.g. change of hands).

Pad the stressed parts of the body or the ground on which you work with soft materials or protectors (e.g. elbow pads, knee pads, etc.). In sports, they should use special bandages or compressions for the appropriate parts of the body.

If you already suffer from bursitis, it is important to completely cure this disease, otherwise there is a risk of renewed inflammation.

Dorothy Farrar

Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.

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