Among all the structures that make up the human body, some are small in size but huge in responsibility. Such are the bursae, without which it would be impossible to move the joints normally. In today’s article, everything about bursitis, which occurs in the hip, shoulders, knees, and elbows and affects the daily life of those who have it.
What is Bursitis?
Bursitis is an inflammation of the synovial bursa (bursa) – a fluid-filled structure located near joints, tendons, muscles, and bones. Its function is to cushion the pressure between two moving surfaces, helping tissues glide smoothly.There are hundreds of bursae throughout the human body. However, their inflammation usually occurs near joints that perform repetitive movements, particularly the shoulder, hip, elbow, and knee.The bursae in the knee and elbow are located just below the skin. In these cases, there is a higher risk of trauma that leads to inflammation. Bursitis can be acute, which is more common, or chronic, usually related to previous injuries that can leave the bursa thickened for a long period.
Causes of Bursitis
The most common cause of bursitis is the repetition of movements in the joints or positions that can damage the bursae. Some situations include:
- Kneeling for long periods
- Sitting on hard surfaces for too long
- Leaning on the elbows
- Practicing sports that require frequent arm lifting
People of any age can develop bursitis. However, some risk factors increase the likelihood of inflammation: aging, playing sports, jobs that require repetitive strain, and other medical conditions such as diabetes, rheumatoid arthritis, and gout.
Trochanteric Bursitis (Hip)
Trochanteric bursitis is the inflammation of the bursa located at the lateral part of the hip. Its role is to protect between the side thigh muscle and the most prominent region of the femur, called the greater trochanter.
Symptoms and Causes
Women are more affected by hip bursitis, and the symptoms are pain in the side of the thigh, radiating to the knee and buttock. The discomfort worsens when pressing on the region and when lying down.Simple activities such as getting up from a chair, getting out of the car, and going up or down stairs become complicated and accentuate the pain dramatically. There are some common factors for this problem:
- Prolonged pressure on the greater trochanter, caused by lying down or staying in the same position for a long time
- Overload resulting from physical activity
- Bruising of the area after a fall
- Hormonal changes, especially after menopause
- Gynecoid hip shape (commonly called saddlebags)
Other causes of trochanteric bursitis can be related to some pre-existing diseases, such as thyroid disorders and fibromyalgia. Aging is also a risk factor: the older the person, the greater the tendency toward inflammation.
Bursitis in the Shoulder
Bursitis in the shoulder occurs when the subacromial-subdeltoid bursa, located beside the shoulder joint, becomes inflamed. This type of bursitis is often associated with the shoulder impingement syndrome, when in addition to bursa inflammation, the muscles that pass through the subacromial region also have tendinitis (inflammation of the tendons).
Symptoms and Causes
Shoulder bursitis causes pain throughout the area, especially the upper part. The patient finds it difficult to raise the arm above the head and experiences muscle weakness. In some cases, there is a tingling sensation that radiates down the arm.The most common cause of shoulder bursitis is overuse of the joint, precisely due to repeated arm lifting – as seen with volleyball athletes or painters, for example. In addition, sudden movements, such as lifting a heavy object without proper posture, can also cause this condition.
Bursitis in the Knee
Each knee has a total of 11 bursae. Any one of them can become inflamed. However, knee bursitis most often occurs over the kneecap or on the inner side of the knee.
Symptoms and Causes
The symptoms of knee bursitis vary from patient to patient and always depend on which bursa is affected. The affected area tends to become warm, swollen, and painful to touch or movement.Most knee bursitis cases also result from repetitive injuries suffered in work or sports where kneeling occurs repeatedly. Other common causes of knee bursitis include:
- Direct blow to the area
- Falls/friction on the knee
- Sprains from exercise, such as jiu-jitsu
- Complications from osteoarthritis, rheumatoid arthritis, or gout
Another reason for knee bursitis is obesity. Excess weight puts more strain on the knees and other joints.
Bursitis in the Elbow
Bursitis in the elbow is also known as olecranon bursitis, due to the bony prominence called the olecranon, which gives the elbow its pointed shape. The bursa is located exactly in this region: at the tip of the elbow.
Symptoms and Causes
Usually, the first symptom noticed is swelling. The skin located behind the elbow is loose, which is why minor changes may not be noticed at first. However, as the swelling persists, the bursa begins to stretch, causing pain – variable, but intense, and it limits movement. Redness in the area may also appear.Elbow bursitis has very similar causes to other types of bursitis. They are:
- Direct trauma to the area
- Prolonged pressure on hard surfaces
- Repetitive movements in certain work or sports functions
- Complications from osteoarthritis, rheumatoid arthritis, or gout
Elbow bursitis drastically limits elbow flexion. Therefore, using an appropriate elbow brace should help minimize discomfort.
Diagnosing Bursitis
A rheumatologist should be consulted. The physician begins with a physical exam aimed at identifying the affected joints. The patient’s history and a discussion about their lifestyle are also important.Afterward, blood and imaging tests are requested. A simple X-ray cannot detect bursitis, but it rules out other diseases. The most requested tests are ultrasound and MRI scans.
Treatment of Bursitis
Initially, the rheumatologist will recommend some measures, such as rest, cold compresses, and prescribing painkillers. In many cases, this treatment is sufficient for bursitis, regardless of the affected area.If the inflammation is caused by infection, antibiotics are prescribed. Additionally, physical therapy and muscle strengthening exercises in the affected area prevent recurrence of the disease.More severe cases may require aspiration to drain fluid from the bursae. Surgery is only recommended when no other type of treatment works.
