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What is bursitis?
Bursitis is an inflammation of the bursae, which are small, fluid-filled sacs that provide cushioning and reduce friction between bones and other tissues, such as muscles, tendons, and skin. This condition can cause pain, swelling, and reduced movement in the affected area. Bursitis commonly affects the joints in the shoulders, elbows, hips, and knees, but it can occur in any bursa in the body. The most common types of bursitis include:
- Trochanteric bursitis: trochanteric bursitis occurs at the hip, specifically at the outer part of the hip near the greater trochanter, which is a bony prominence on the femur (thigh bone).
- Olecranon bursitis: olecranon bursitis is an inflammation of the bursa located over the olecranon process, the pointed bone at the tip of the elbow.
- Prepatellar bursitis: prepatellar bursitis is an inflammation of the bursa in front of the kneecap (patella), often caused by frequent kneeling or direct trauma to the knee.
- Subacromial bursitis: subacromial bursitis is the inflammation of the bursa located under the acromion, the bony point at the top of the shoulder. It often leads to shoulder pain and restricted movement.
- Retrocalcaneal bursitis: retrocalcaneal bursitis is the inflammation of the bursa between the Achilles tendon and the calcaneus (heel bone), which causes pain and swelling at the back of the heel.
What causes bursitis?
Bursitis is caused by the inflammation of bursae, which are fluid-filled sacs that cushion between bones, tendons, and muscles. Here are the common causes of bursitis:
- Repetitive motion or overuse: repeated activities that stress a joint can irritate and inflame the bursa. For example, throwing a baseball, lifting objects overhead, or kneeling for long periods can lead to bursitis in the respective joints.
- Prolonged pressure: sitting or lying in the same position for an extended time can increase pressure on the bursae, leading to inflammation. For instance, sitting on a hard surface for extended periods might cause bursitis in the hip or buttock area.
- Injury or trauma: a direct blow to a joint or falling on it can cause sudden bursitis. The impact can lead to swelling and inflammation of the bursae.
- Infection: sometimes, a bursa can become infected with bacteria, which can cause septic bursitis. This condition is more serious and often requires antibiotic treatment.
What are the symptoms of bursitis?
The symptoms of bursitis vary depending on the affected joint but commonly include:
- Pain: the area around the affected joint may feel achy or stiff, and the pain may increase with movement or pressure.
- Swelling and redness: the affected area might swell and appear red or warm to the touch, indicating inflammation.
- Limited range of motion: joint movement may be restricted due to pain and swelling, making it difficult to perform everyday activities.
- Tenderness: the area over the inflamed bursa can be particularly sensitive to touch.
- Stiffness: the joint may feel stiff, especially after periods of inactivity or in the morning.
The onset of these symptoms can be gradual, resulting from repetitive activities, or sudden, due to an injury or infection. If the bursitis results from an infection (septic bursitis), symptoms may also include fever, chills, and a feeling of overall illness. If any of these symptoms are severe or do not improve with basic home care, medical attention should be sought.
Is bursitis a painful condition?
Yes, bursitis can be a painful condition. The level of pain experienced varies depending on the severity and location of the inflammation. In cases of acute bursitis, the pain can be sharp and intense, especially when the affected joint is moved, or pressure is applied to it. Chronic bursitis, which is a longer-term condition, may cause a persistent, dull ache and stiffness in the affected area. The pain from bursitis is often worsened by continued use or pressure on the inflamed bursa.
Who is at risk of bursitis in Singapore?
Various factors, including occupation, lifestyle, and health conditions, influence the risk of bursitis in Singapore. Here are some groups who may be at higher risk:
- Ageing population: older adults are more prone to bursitis because of wear and tear on the joints over time and decreased elasticity in the tendons.
- Workers in manual jobs: individuals engaged in occupations that require repetitive motion or prolonged pressure on joints, such as construction workers, gardeners, and cleaners, are at higher risk due to the stress placed on their joints.
- Athletes: people who regularly participate in sports, especially those that involve repetitive movements (like running, tennis, or golf), can be more susceptible to bursitis.
- Individuals with certain health conditions: individuals with rheumatoid arthritis, diabetes, and gout have a higher incidence of bursitis due to underlying inflammation and metabolic factors.
- People with poor posture or improper body mechanics: poor posture or improper techniques when lifting or performing physical activities may put extra stress on their bursae.
In Singapore, the urban lifestyle and work environment can also contribute to the risk factors, especially among individuals who spend long hours at a desk or computer. This leads to potential strain and bursitis in the shoulder or elbow.
How is bursitis diagnosed?
Bursitis is typically diagnosed through a combination of clinical evaluation and diagnostic tests:
- Medical history and physical examination: your specialist will start with a detailed medical history, asking about symptoms, activities that may have led to the condition, and any past injuries. During the physical exam, the area will be examined to check for tenderness, swelling, redness, and range of motion in the affected joint.
- Imaging tests:
- X-rays: these can rule out other conditions that might cause symptoms similar to bursitis, such as fractures or arthritis.
- Ultrasound: an ultrasound can help visualise the swollen bursa and is useful in diagnosing bursitis, especially in soft tissue structures.
- Magnetic resonance imaging (MRI): although not commonly needed for diagnosing bursitis, an MRI can provide detailed images of both soft tissues and bones, which can help identify bursitis and differentiate it from other conditions.
The diagnosis aims to confirm the presence of bursitis, identify the affected bursa, and determine whether the condition is caused by infection, injury, or an underlying health issue. This comprehensive approach helps formulate an effective treatment plan.
What are the treatment options for bursitis in Singapore?
Treatment for bursitis focuses on relieving pain and inflammation and addressing the underlying causes to prevent recurrence. Here are the common treatment options for bursitis:
- Rest and activity modification: it is crucial to avoid activities that exacerbate the condition. Resting the affected joint helps reduce inflammation and pain.
- Ice therapy: applying ice to the affected area can help reduce swelling and numb the area, relieving pain.
- Medications:
- Pain relievers: over-the-counter pain medications, such as ibuprofen or acetaminophen, can help alleviate the pain.
- Anti-inflammatory drugs: nonsteroidal anti-inflammatory drugs (NSAIDs) can reduce inflammation and pain.
- Ultrasound guided injections: for severe cases, a corticosteroid drug may be injected into the bursa to reduce inflammation and pain quickly.
- Physical therapy: a physical therapist can teach exercises to strengthen the muscles around the joint, improve flexibility, and reduce the risk of future episodes of bursitis.
- Assistive devices: pads, cushions, or braces can help reduce pressure on the affected joint.
The treatment choice depends on the severity of the symptoms, the specific bursa affected, and the underlying cause. It is important for individuals with bursitis to follow their healthcare provider’s recommendations and complete the course of treatment to resolve the condition and prevent its recurrence.
If you are experiencing bursitis, schedule an appointment with us today for a thorough diagnosis and an appropriate treatment plan.
Frequently asked questions
Bursitis itself does not typically lead to permanent joint damage. However, chronic inflammation can cause complications like a reduced range of motion or tendon damage if left untreated.
Certain exercises, especially repetitive motion or high stress on the affected joint, can exacerbate bursitis symptoms. It is important to modify activities and exercise under guidance to avoid worsening the condition.
No, bursitis is not the same as arthritis. Bursitis is an inflammation of the bursa, a fluid-filled sac that reduces friction. At the same time, arthritis involves inflammation of the joints themselves, which often affects the cartilage, bone, and synovial fluid within the joint.
Yes, bursitis can recur, especially if the activities or conditions that initially caused it are not modified or addressed. Preventive measures, such as ergonomic adjustments and regular exercise, can help reduce the risk of recurrence.
Total Pain Specialist