Difference between revisions of "Bursitis" - New World Encyclopedia

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'''Bursitis''' is the [[inflammation]] of one or more [[Bursa (anatomy)|bursae]], or small sacs of [[synovial fluid]], in the body. Bursae rest at the points where internal functionaries, like [[muscle]]s and [[tendon]]s, slide across [[bone]]. Healthy bursae create a smooth and almost frictionless gliding surface. With hundreds of them throughout the body they provide this surface for all motion, making movement normally painless. When bursitis takes hold, however, movement that relies on the inflamed bursa become rough and painful. Movement of tendons and muscles over the inflamed bursa causes it to become more inflamed, perpetuating the problem.
+
'''Bursitis''' is the [[inflammation]] of one or more [[Bursa (anatomy)|bursae]].  
  
==Causes==
+
A bursa (plural bursae) is a closed, fluid-filled sac that surrounds joints or [[tendon]]s. It functions as a cushion and gliding surface to reduce friction between [[muscle]]s, tendons, and [[bone]]s as they move back and forth across each other. The major bursae are located adjacent to the tendons near the large joints, like shoulders, elbows, hips, and knees.
  
Bursitis is commonly caused by repetition of movement or excessive pressure. [[Elbow-joint|Elbow]]s and [[knee]]s are the most commonly affected because they are rested upon more than many parts of the body with bursae and they also get the most repetitive use. Inflammation of bursae can also be caused by other inflammatory conditions such as [[rheumatoid arthritis]]. [[Scoliosis]] can also be a cause of bursitis of the shoulders.
+
Bursitis, an inflammation of a bursa, is usually a temporary condition that may restrain motion, and it generally does not cause deformity. It is common among people in sports such as [[baseball]], [[tennis]], [[racquetball]], and running. But even everyday household jobs such as yard work, shoveling dirt or snow, and house painting can cause bursitis.
  
The other main cause of bursitis is traumatic injury, which can cause swelling of the bursae. The swelling itself causes irritation because the sac will no longer fit in the small area between the bone and the functionary.  When the bone begins to increase pressure on the bursa, bursitis ensues.
+
Bursitis is often associated with other diseases, such as arthritis, thyroid disease, and diabetes.
  
==Symptoms==
+
==Causes and types==
Symptoms can vary from an ache and stiffness in the local area of the joint, to a burning that surrounds the whole joint around the inflamed bursa. With this condition, the pain is usually worse during and after activity, and the bursa and surrounding joint area can become stiffer the following day.
 
  
==Examples==
+
Individuals in poor physical condition and with bad postures are at risk of developing bursitis.  
The most common examples of this condition are [[Prepatellar bursitis]], [[Trochanteric bursitis]], [[Olecranon bursitis]] and [[Subacromial bursitis]].
 
  
==External links==
+
Injury or overuse is what usually causes bursitis. It may also occur by using an affected limb incorrectly. [[Infection]] can be a probable cause as well.
*[http://orthopedics.about.com/cs/sportsmedicine/a/blbursitis.htm About.com's General Bursitis Information]
+
 
*[http://www.mayoclinic.com/health/bursitis/DS00032/DSECTION=1 Information from the] [[Mayo Clinic]]
+
Another way that bursitis occurs is when compression of the bursa happens on a regular basis, such as a side sleeper who places a lot of shoulder or hip pressure on the area when they lay down for long periods. In this case, it would not take too much movement of this already compressed area to cause friction of the bursa.    
*[http://www.bursitis.org Bursitis Prevention]
+
 
*[http://meded.ucsd.edu/isp/2005/orthopedic/Shoulder%20Disorders/subacromial_bursitis.htm Subacromial bursitis]
+
The type of bursitis that affects each person varies, as it strikes the areas which are overused or on which pressure is applied the most:
*[http://www.mymedicenter.com/arthritis/what-is-bursitis.html MyMedicenter]
+
 
[[Category:Inflammations]]
+
*'''Kneecap bursitis''', which is also called ''housemaid's knee'' and is medically known as ''prepatellar bursitis'', results from kneeling on a hard or raised surface for long periods. This type of bursitis is common among skilled laborers like carpet layers and plumbers, who need to sit on their knees a lot.
 +
 
 +
* '''Elbow bursitis''', known medically as ''olecranon bursitis'' and also nicknamed ''student's elbow'', results from repeated pressure on the point of the elbow. Inflammation of the olecranon bursa located between the [[skin]] and [[bone]]s of the elbow is what causes this type of bursitis. It often occurs when there is constant pressure on the elbow doing something as simple as leaning on a hard surface, such as someone leaning on a table or desk for a long time.
 +
 
 +
* '''Knee bursitis''', known also as ''goosefoot bursitis'' or ''Pes Anserine bursitis'', affects the bursa located between the shin bone and the three tendons of the hamstring muscles, on the inside of the knee. This is usually caused by lack of stretching before exercise, tight hamstring muscles, being overweight, [[arthritis]], or out-turning of the knee or lower leg.
 +
 
 +
* '''Anterior Achilles tendon bursitis''', also called ''Albert's disease'', is caused by extra strain on the [[Achilles tendon]], such as injury, [[disease]], or shoes with rigid back support. It is characterized by [[inflammation]] of the bursa located in front of the attachment of the tendon to the heel.
 +
 
 +
* '''Posterior Achilles tendon bursitis''', otherwise called ''Haglund's deformity'', is inflammation of bursa located between the skin of the heel and the Achilles tendon, which attaches the calf muscles to the heel. Aggravated by a type of walking that presses the soft heel tissue to the hard, back support of a shoe, this type of bursitis occurs mostly among young women.
 +
 
 +
*'''Hip bursitis''', or ''trochanteric bursitis'', is often the result of injury, overuse, spinal abnormalities, arthritis, or [[surgery]]. This type of bursitis is also more common among women, apart from middle-aged and older people.
 +
 
 +
==Signs and symptoms==
 +
 
 +
The symptoms of Bursitis can be as varied as the causes and types of bursitis. It can range from an achy [[pain]] and stiffness to even a burning sensation on the area surrounding the joint with the inflamed bursa. The pain usually escalates during and after activity, with the bursa and the surrounding joint area becoming stiffer the following day.
 +
 
 +
Apart from pain, one finds localized tenderness and limited motion to be common among people who have bursitis. Swelling and redness also occurs if the inflamed bursa is close to the surface.
 +
 
 +
Repeated attacks of pain, swelling, and tenderness, leading to the deterioration of muscles and a limited range-of-motion, is a case of chronic bursitis.
 +
 
 +
==Diagnosis==
 +
 
 +
Firstly, an analysis of complete medical history and physical examination is mandatory. As the symptoms of bursitis resemble other medical conditions or problems, an accurate diagnosis is important. So other intensive diagnostic procedures are also employed.
 +
 
 +
A sample of fluid from the bursa is obtained to rule out infections and to find the cause of the bursitis. And apart from x-rays and blood tests, other tests may also be required:
 +
 
 +
• Computed tomography scan ( CT or CAT scan)
 +
• Magnetic resonance imaging (MRI)
 +
• Arthrogram to provide evidence of a tear, opening, or blockage.
 +
• Aspiration to rule out infection or gout as causes.
 +
 
 +
 
 +
 
 +
Prevention
 +
 
 +
Bursitis can be prevented by doing stretching exercises regularly, especially before and after heavy workouts. Stretching muscles lengthens tendon connections around the bursa, allowing less friction to the tendon/bursa/bone connections.
 +
 +
Relaxation techniques also help to reduce pressure on the bursa and to keep it from losing its natural lubrication.  Wearing a protective pad can also help avoid pressure and injury to the joint. When bursitis does occur, it is important to treat it immediately, and thereby prevent it from reaching a stage that is more severe.
 +
 
 +
In bursitis, the bursa is inflamed but not infected. If the swelling spreads despite treatment or if you develop fever, chills, or increased warmth, these are signs of possible infection.
 +
 
 +
 
 +
 
 +
Treatment
 +
 
 +
Treatment for this condition is determined by several factors:
 +
• Age, overall health and medical history
 +
• Extent of the condition
 +
• Patient’s tolerance for specific medications, procedures, or therapies
 +
• Expectations for the course of the condition
 +
 
 +
Personal preferences and the possibility of an infection also play a role in treatment. The treatment for bursitis also depends on whether or not it involves infection.
 +
 
 +
In the case of aseptic bursitis - a non-infectious condition, treatment may include:
 +
 
 +
Rest
 +
Do not put any pressure on the sore and swollen area until the swelling subsides. Rest the affected area such as the shoulder, elbow, knee, or hip. And wait 3 to 6 weeks before returning to the sport or task that originally caused your condition.
 +
 
 +
Ice
 +
Put an ice pack on the area for 20 to 30 minutes 3 or 4 times a day to help relieve pain. But it important not to do this more often, as it can constrict the blood vessels and further stiffen the joint area.
 +
 
 +
Compression
 +
Wear a compression wrap around the affected area such as the elbow or knee. It is important to support and protect the bursa by bracing any areas of the tendon that are being pulled on during use, as this will help stop bursa friction from occurring.
 +
 
 +
The pressure on the bursa can also be reduced while sleeping by using a softer bed topper like a memory foam mattress pad or even getting a new mattress that is composed with memory foam or latex foam.  Memory foam and latex foam reduce compression because they are the only substances that conform with the bumps and curves of the body and can thereby reduce the pressure spot by more evenly disbursing the weight of the body.
 +
 
 +
Elevation
 +
While resting, keep the affected area at an elevation.
 +
 
 +
Pain relief
 +
Reducing bursa inflammation and soothing the pain of bursitis can be done topically with pain relievers containing anti-inflammatory agents. A topical formula with natural menthol will not only relieve pain, but also dilate the blood vessels. This allows for relief of the bursitis, without causing any stiffening of the tissue.
 +
 
 +
Anti-inflammatory and pain medications such as ibuprofen or aspirin are usually prescribed. Cortisone injections can also reduce inflammation, but they are very caustic and can cause a weakening of the tissue structure and sometimes create more scar tissue.
 +
 
 +
Physical therapy
 +
This may involve stretching and strengthening exercises. Also maintain your range of motion by moving the joint to help keep the joint from getting stiff.
 +
 
 +
Soft tissue manipulation
 +
Methods such as ultrasound and massage are also used to help break down the scar tissue in the tendon tissue and let the tendon and muscle regain normal flexibility. This can lessen the chance of further injury.
 +
 
 +
Ultrasound uses sound waves to increase circulation to the tissue and soften the scar tissue, allow it to break down further.  Ultrasound can also be used as phonophoresis to help topical pain and nutrient solutions reach further down into the tissues by transporting them with the sound waves.  
 +
 
 +
 
 +
In the case of septic bursitis - bursa that becomes infected with bacteria, treatment may also include:
 +
 
 +
• Antibiotic medications
 +
• Repeated aspiration of the inflamed fluid
 +
• Surgical drainage and removal of the infected bursa sac (bursectomy)
 +
 
 +
With treatment, the pain and swelling of bursitis usually clear up within 2 to 3 weeks. But the healing of the area continues and doesn't even peak until at least six weeks following the initial injury.
 +
 
 +
This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together.  Scar tissue continues to form past six weeks in some cases and as long as a year in severe cases. After 6 months, if this condition persists, it is considered chronic.
 +
 
 +
 
 +
References
 +
Retrieved from:
 +
 
 +
http://wo-pub2.med.cornell.edu
 +
 
 +
• http://www.med.umich.edu
 +
 
 +
http://www.bursitis.org
  
{{health-stub}}
 
  
 
[[Category:Life sciences]]
 
[[Category:Life sciences]]
 
{{credit|129274918}}
 
{{credit|129274918}}

Revision as of 01:45, 2 June 2007

Bursitis
Classification and external resources
Bursitis Elbow WC.JPG
Bursitis of the Elbow
ICD-10 M71.9
ICD-9 727.3
DiseasesDB 31623
MedlinePlus 000419
eMedicine emerg/74 
MeSH D002062

Bursitis is the inflammation of one or more bursae.

A bursa (plural bursae) is a closed, fluid-filled sac that surrounds joints or tendons. It functions as a cushion and gliding surface to reduce friction between muscles, tendons, and bones as they move back and forth across each other. The major bursae are located adjacent to the tendons near the large joints, like shoulders, elbows, hips, and knees.

Bursitis, an inflammation of a bursa, is usually a temporary condition that may restrain motion, and it generally does not cause deformity. It is common among people in sports such as baseball, tennis, racquetball, and running. But even everyday household jobs such as yard work, shoveling dirt or snow, and house painting can cause bursitis.

Bursitis is often associated with other diseases, such as arthritis, thyroid disease, and diabetes.

Causes and types

Individuals in poor physical condition and with bad postures are at risk of developing bursitis.

Injury or overuse is what usually causes bursitis. It may also occur by using an affected limb incorrectly. Infection can be a probable cause as well.

Another way that bursitis occurs is when compression of the bursa happens on a regular basis, such as a side sleeper who places a lot of shoulder or hip pressure on the area when they lay down for long periods. In this case, it would not take too much movement of this already compressed area to cause friction of the bursa.

The type of bursitis that affects each person varies, as it strikes the areas which are overused or on which pressure is applied the most:

  • Kneecap bursitis, which is also called housemaid's knee and is medically known as prepatellar bursitis, results from kneeling on a hard or raised surface for long periods. This type of bursitis is common among skilled laborers like carpet layers and plumbers, who need to sit on their knees a lot.
  • Elbow bursitis, known medically as olecranon bursitis and also nicknamed student's elbow, results from repeated pressure on the point of the elbow. Inflammation of the olecranon bursa located between the skin and bones of the elbow is what causes this type of bursitis. It often occurs when there is constant pressure on the elbow doing something as simple as leaning on a hard surface, such as someone leaning on a table or desk for a long time.
  • Knee bursitis, known also as goosefoot bursitis or Pes Anserine bursitis, affects the bursa located between the shin bone and the three tendons of the hamstring muscles, on the inside of the knee. This is usually caused by lack of stretching before exercise, tight hamstring muscles, being overweight, arthritis, or out-turning of the knee or lower leg.
  • Anterior Achilles tendon bursitis, also called Albert's disease, is caused by extra strain on the Achilles tendon, such as injury, disease, or shoes with rigid back support. It is characterized by inflammation of the bursa located in front of the attachment of the tendon to the heel.
  • Posterior Achilles tendon bursitis, otherwise called Haglund's deformity, is inflammation of bursa located between the skin of the heel and the Achilles tendon, which attaches the calf muscles to the heel. Aggravated by a type of walking that presses the soft heel tissue to the hard, back support of a shoe, this type of bursitis occurs mostly among young women.
  • Hip bursitis, or trochanteric bursitis, is often the result of injury, overuse, spinal abnormalities, arthritis, or surgery. This type of bursitis is also more common among women, apart from middle-aged and older people.

Signs and symptoms

The symptoms of Bursitis can be as varied as the causes and types of bursitis. It can range from an achy pain and stiffness to even a burning sensation on the area surrounding the joint with the inflamed bursa. The pain usually escalates during and after activity, with the bursa and the surrounding joint area becoming stiffer the following day.

Apart from pain, one finds localized tenderness and limited motion to be common among people who have bursitis. Swelling and redness also occurs if the inflamed bursa is close to the surface.

Repeated attacks of pain, swelling, and tenderness, leading to the deterioration of muscles and a limited range-of-motion, is a case of chronic bursitis.

Diagnosis

Firstly, an analysis of complete medical history and physical examination is mandatory. As the symptoms of bursitis resemble other medical conditions or problems, an accurate diagnosis is important. So other intensive diagnostic procedures are also employed.

A sample of fluid from the bursa is obtained to rule out infections and to find the cause of the bursitis. And apart from x-rays and blood tests, other tests may also be required:

• Computed tomography scan ( CT or CAT scan) • Magnetic resonance imaging (MRI) • Arthrogram to provide evidence of a tear, opening, or blockage. • Aspiration to rule out infection or gout as causes.


Prevention

Bursitis can be prevented by doing stretching exercises regularly, especially before and after heavy workouts. Stretching muscles lengthens tendon connections around the bursa, allowing less friction to the tendon/bursa/bone connections.

Relaxation techniques also help to reduce pressure on the bursa and to keep it from losing its natural lubrication. Wearing a protective pad can also help avoid pressure and injury to the joint. When bursitis does occur, it is important to treat it immediately, and thereby prevent it from reaching a stage that is more severe.

In bursitis, the bursa is inflamed but not infected. If the swelling spreads despite treatment or if you develop fever, chills, or increased warmth, these are signs of possible infection.


Treatment

Treatment for this condition is determined by several factors: • Age, overall health and medical history • Extent of the condition • Patient’s tolerance for specific medications, procedures, or therapies • Expectations for the course of the condition

Personal preferences and the possibility of an infection also play a role in treatment. The treatment for bursitis also depends on whether or not it involves infection.

In the case of aseptic bursitis - a non-infectious condition, treatment may include:

Rest Do not put any pressure on the sore and swollen area until the swelling subsides. Rest the affected area such as the shoulder, elbow, knee, or hip. And wait 3 to 6 weeks before returning to the sport or task that originally caused your condition.

Ice Put an ice pack on the area for 20 to 30 minutes 3 or 4 times a day to help relieve pain. But it important not to do this more often, as it can constrict the blood vessels and further stiffen the joint area.

Compression Wear a compression wrap around the affected area such as the elbow or knee. It is important to support and protect the bursa by bracing any areas of the tendon that are being pulled on during use, as this will help stop bursa friction from occurring.

The pressure on the bursa can also be reduced while sleeping by using a softer bed topper like a memory foam mattress pad or even getting a new mattress that is composed with memory foam or latex foam. Memory foam and latex foam reduce compression because they are the only substances that conform with the bumps and curves of the body and can thereby reduce the pressure spot by more evenly disbursing the weight of the body.

Elevation While resting, keep the affected area at an elevation.

Pain relief Reducing bursa inflammation and soothing the pain of bursitis can be done topically with pain relievers containing anti-inflammatory agents. A topical formula with natural menthol will not only relieve pain, but also dilate the blood vessels. This allows for relief of the bursitis, without causing any stiffening of the tissue.

Anti-inflammatory and pain medications such as ibuprofen or aspirin are usually prescribed. Cortisone injections can also reduce inflammation, but they are very caustic and can cause a weakening of the tissue structure and sometimes create more scar tissue.

Physical therapy This may involve stretching and strengthening exercises. Also maintain your range of motion by moving the joint to help keep the joint from getting stiff.

Soft tissue manipulation Methods such as ultrasound and massage are also used to help break down the scar tissue in the tendon tissue and let the tendon and muscle regain normal flexibility. This can lessen the chance of further injury.

Ultrasound uses sound waves to increase circulation to the tissue and soften the scar tissue, allow it to break down further. Ultrasound can also be used as phonophoresis to help topical pain and nutrient solutions reach further down into the tissues by transporting them with the sound waves.


In the case of septic bursitis - bursa that becomes infected with bacteria, treatment may also include:

• Antibiotic medications • Repeated aspiration of the inflamed fluid • Surgical drainage and removal of the infected bursa sac (bursectomy)

With treatment, the pain and swelling of bursitis usually clear up within 2 to 3 weeks. But the healing of the area continues and doesn't even peak until at least six weeks following the initial injury.

This is due to scar tissue formation, which initially acts like the glue to bond the tissue back together. Scar tissue continues to form past six weeks in some cases and as long as a year in severe cases. After 6 months, if this condition persists, it is considered chronic.


References Retrieved from:

http://wo-pub2.med.cornell.edu

http://www.med.umich.edu

http://www.bursitis.org

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