Bursitis is a fairly common complaint and is most often caused by repetitive minor impact on the area protected by bursae. Bursae are little sacs filled with lubricating fluid located between tissues such as bone, muscle, tendons and skin that serve to protect by reducing friction between the tissues. Sometimes bursitis is caused by a sudden more serious injury but usually it signals an overuse problem. Age also plays a part in the onset of bursitis because as tendons age they become less elastic and less able to withstand stress.
Some of the high-risk activities that are commonly associated with the onset of bursitis are gardening, raking, carpentry, painting, scrubbing, tennis, golf, skiing, throwing and other repetitive movements. Incorrect posture, poor conditioning and lack of flexibility can all lead to bursitis.
Length differences in the legs or arthritis in a joint can put added stress on a bursa sac, leading to bursitis. Stress and inflammation from other conditions such as rheumatoid arthritis. gout, psoriatic arthritis, thyroid disorders, or an infection, and some medications can also bring about bursitis.
Bursitis is most common in adults over the age of 40, and most commonly diagnosed in the shoulder, elbow, hip, knee and heel or Achilles tendon. The most frequent symptom is pain that may gradually increase or be quite sudden and severe, especially if calcium deposits are present in the joint.
A condition known as “frozen shoulder” (adhesive capsulitis) associated with bursitis results in immobility of the shoulder joint. “Housemaid’s knee” is another common term used to indicate bursitis in the knee.
When planning an exercise routine, it is imperative to start slowly and progress rather than jumping in with both feet. A range of motion warm-up is crucial and proper execution of each exercise is of utmost importance. If there is pain associated with any movement, stop. Pain is an indication that something is wrong, it is not an invitation to “push past the pain.”
Obviously, any activity that aggravates the problem should be avoided. Rest and ice are easy and effective household treatments for bursitis. Also avoid any direct pressure on the bursa. Non-steroidal anti-inflammatory drugs (NSAIDs) — such as aspirin — are also an option.
Any underlying gait issues should be resolved with the use of a shoe lift to correct leg length imbalances, custom orthotics for ankle pronation, and stretching exercises to increase the flexibility of the tendons in the back and legs and shoulders.
Hip bursitis is more commonly found in women over the age of 40. The repetitive overuse injury may be a common reason for hip bursitis but also a sudden fall can lead to the problem. Other causative factors are spine conditions such as scoliosis, osteoarthritis — the leg length discrepancy — or knee or ankle sprain or osteoarthritis. Previous surgery to the hip especially hip implants can lead to bursitis and bone spurs and may aggravate the bursae during normal daily activities.
If the pain continues for over a week, it is recommended that you see your doctor who may prescribe a steroid such as a corticosteroid to decrease the inflammation. Sometimes the steroid will be injected directly into the inflamed joint. Another medical option may be physical therapy to encourage range of motion exercises and also the use of ultrasound therapy.
Rarely, the inflamed bursa will be surgically excised if other methods of treatment have failed. If there is fever associated with the joint pain, or swelling or redness, a rash, or a general feeling on being unwell, or inability to move the affected joint, you should see your doctor immediately.
If there is an open wound around the site of the bursitis, you should consult your physician as well. Your doctor will be able to determine whether you have bursitis or perhaps another issue such as synovitis or cellulitis.
If you are sore in the joints, consult your doctor; and once you get better, start a life of sensible proactive activity and exercise programming that will lead to full mobility and health.
Dr. Jane Riley, Ed.D., is a certified personal fitness trainer, certified nutritional adviser and certified behavior change specialist. She can be reached at firstname.lastname@example.org (808) 212-8119 cell/text, www.janerileyfitness.com.