Within certain joints of our body, we can find a bursa that is a small `` bag '' with a small amount of liquid whose function is to serve as a pad for the tendons, muscles and bones of said joint, thus helping their movement and to reduce friction between them.
When we talk about itis ’-itis’ ’we are referring to inflammation. Thus, the term bursitis means that this bursa is inflamed, causing pain and, therefore, movement limitation.
What are the causes?
Its main cause is overuse of the joint (overload), which can be due to continuous and repetitive movements or some type of overexertion in its activity.
Another common cause is trauma, that is, direct blows to the joint or falls.
Less commonly, but we can also find it, it is caused by infections or other diseases such as rheumatoid arthritis or gout.
What do we feel when we have bursitis?
As we have explained before, the bursae are part of the joints and therefore, depending on the bursa (and the joint) that is affected, we will have one symptomatology or another. But regardless of the area affected, as occurs whenever there is an inflammatory process, the main symptoms will be:
Pain in the affected area
Inability to perform the movement properly (mainly a consequence of this pain).
Sometimes we can even find redness of the area along with swelling.
Diagnosis
The most important thing to have a good diagnosis (as in any other pathology) is to carry out a good anamnesis (questions for data collection). The human body is a very complex structure and many times it presents us with pain in an area that does not have to be affected. In this way, by asking the appropriate questions to the patient, we will be able to obtain a better diagnosis and thereby direct the best treatment.
Of course, we cannot ignore the physical examination and thus correlate the data that our patient has given us with what we obtain in palpation and mobility.
What are the most frequent bursitis?
As we have said that the main cause is overuse, the bursitis that we can find most frequently are those of the shoulder, knee and hip mainly, although they are also common in other joints that have frequent movement on a daily basis such as the elbow, the foot and wrist.
Hip bursitis (trochanteric bursitis)
It is mainly caused by an excessive friction of the tensor fascia lata muscle (located on the side of the leg) with the trochanter (bony protrusion of the head of the femur). This is one of the most frequent causes of hip pain.
Shoulder bursitis (subacromial or subdeltoid bursitis)
It is mainly produced by the overuse of the supraspinatus muscle since its tendon passes over the bursa, especially when movements of the arm are made for a long time (movement performed by the arm).
Knee bursitis
The most frequent knee bursitis is the one that occurs in the pre-patellar bursa, which is the one found on the anterior aspect of the knee, above the patella. This usually happens through a traumatic mechanism to people who spend a lot of time on their knees. It is also frequent to find an inflammation of the bursa of the goose leg (set of tendons on the internal and anterior aspect of the knee), the cause of which is their overload.
What to do if I have bursitis?
To determine well what to do in this situation, it is important to know why it has occurred. It is not the same if the bursitis is caused by overuse at the muscular level than if it has been the result of trauma. This must be taken into account since the main and most important thing to recover that joint is the approach to the cause that caused the problem and not only the treatment of the symptoms.
Manual Therapy
Even so, being a pathology that gives pain and also limitation in joint movement, it is important that we treat this at the same time. For this we will use manual physical therapy together with techniques that will improve pain and therefore allow greater movement and joint performance. At the same time, we can combine this therapy with medications such as anti-inflammatories and pain relievers and even cryotherapy (application of cold in the area).
After treating the symptoms, we will address the cause:
If it is muscular we will do it with relaxation of the affected musculature, corrections with exercises.
If it is traumatic with the avoidance of the position or the traumatic process.
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