Bursitis is perhaps the most misunderstood and misdiagnosed condition affecting the body. A bursa is a fluid filled sac that your body uses to decrease friction. They are typically found near the point that tendons attach to bone, such as at the elbow, kneecap, and hip, so that the tendon slides harmlessly over the bursa and does not get damaged by the hard surface of the bone. Bursitis is the condition that occurs when there is an inflammatory response in the bursa. This is fairly easy to recognise as there will be swelling, heat, redness, and the area will also be tender to pressure. Bursa can affect the kneecap (frequently seen in carpenters or floor layers), the tip of the elbow (often seen in students leaning on their desks with the bony part of their elbows), the outer hip (due to falls or impact injuries), and the top part of the shoulder (seen in overhead jobs or sports). A person affected with a true bursitis will often still be able to move the body area in some directions with minimal pain or restriction, but will get pain if the inflamed bursa is pinched or has direct pressure on it. Bursitis is also commonly very sore in bed at night-time so can affect sleep.
Treatment for this condition is quite simple.
- Firstly, remove or avoid any direct pressure on the affected area. This will likely mean modifying the way you perform certain tasks and by wearing loose fitting clothing.
- Those of you who perform activities requiring long periods of time on your knees, such as gardening, should wear knee pads as habit. This will prevent irritation of the many bursa-related problems at the knee.
- If you are a side sleeper, be sure to alternate sides regularly to avoid irritating the bursa at the hip when you lie on your side.
- When studying or reading at a desk for long periods of time, avoid aggravating the bursa on the tip of your elbow by not leaning directly on the bony points of your elbows.
- Working with your arms overhead for long periods of time can often irritate and pinch the bursa at the top of your shoulder, so ensure you lower your arms and rest frequently during such activity.
- Secondly, to help control inflammation in a bursa, use ice on the affected area for 10-15 minutes at a time, and for several times a day. Make sure the ice is making light contact only. It may be also of benefit to see your GP regarding a short-term course of anti-inflammatories.
- Thirdly, if the inflammation persists for more than 2-3 days further measures may be required, such as a visit to your physiotherapist. Your physiotherapist will be able to perform an assessment of the area to determine if there are any surrounding factors such as muscle tightness or weakness that may have inclined you to developing the bursitis in the first place.
A physiotherapist will thoroughly assess the range of motion of the affected area and surrounding joints and the strength of the related muscles, in order to determine the mechanical cause of the bursitis. Hands-on manual therapy treatment and ultrasound are often very effective ways to treat bursitis and appropriate exercises will be given in order to stretch or strengthen the muscles and joints that need it. Once the mechanical problems are taken care of and the inflammation is resolved the pain will subside and normal activity can be resumed.
Treatment of hip, knee and shoulder pain is one of our specialties at The Physiotherapy Place. If you want to learn more or speak with an expert physiotherapist about your specific case, get in touch to arrange a FREE 15 minute telephone consultation.
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