Hip, Knee, Elbow and Shoulder BursitisThe bursae (plural of bursa) are fluid-filled sacs that are distributed throughout the body in locations where different types of tissue press against one another. To better understand the causes of bursitis (inflammation of a bursa), it is helpful to first consider the role played by the bursae in the body.
What is the function of bursae?
Made of connective tissue and mucous membrane, the bursae act as cushions and gliding surfaces between different types of tissue in the body (e.g. bones and tendons). The function of the bursae is to protect structures in the body that come into direct contact with one another against the destructive force of excessive friction.
Bursitis occurs most frequently in the hips, elbows, knees and shoulders. While the exact symptoms may vary depending on the structure in the body that is involved, one symptom is almost always present: pain.
The shoulder bursa is located in the narrow space just under the acromion (the top of the shoulder). Any additional narrowing of this already very limited subacromial space will expose the shoulder bursa to greater pressure. As a result, it may become inflamed and require even more space. Given that the subacromial space is narrowed yet further when we raise our arm, doing so can be expected to intensify the pain of bursitis.One of the bursae in the knee joints is located just under and in front of kneecap. This bursa enables the tendon to glide when we bend and extend our knees. Certain activities, such as working on our hands and knees expose this bursa to elevated pressure, and can cause bursitis, i.e. inflammation and swelling in the bursa.
Like the knee joint, the elbow is also outfitted with a bursa that is particularly exposed on the outside of the elbow. Repeatedly applying pressure to this bursa as well as its exposure to sharp impacts can lead to chronic bursitis.
Causes of Bursitis:
- Mechanical irritation (repetitive motion stress)
- Pressure or excessive stress above or below a bony protuberance
- Bacterial infection
- Rheumatoid arthritis
- Crystal arthropathy (gout, calcium deposits)
Effective treatment for the pain associated with bursitis depends on a precise determination of the cause.
Treatment for Bursitis
Treatment for bursitis is generally conservative, including physical therapy with cold compresses and injections. If your doctor determines the presence of a bacterial infection, such treatment will usually include the administration of an antibiotic.
More intensive forms of physical therapy may be helpful depending on the cause and current extent of the bursitis. At our clinic, such additional measures include high-energy shockwave therapy. The application of high-energy shockwave therapy for chronic bursitis may represent an effective alternative to bursectomy (the surgical removal of a bursa).
More information:
- Knee Bursitis
- Hip Bursitis
- Shoulder Bursitis
- Elbow Bursitis
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