Bursitis (bursitis)

Bursitis - also known as bursitis - usually arises in particularly stressed joints such as the shoulders, elbows or knees. While the inflammation is initially only noticeable by a slight feeling of friction, symptoms such as severe pain, as well as reddening and overheating of the affected area can occur over time. For the treatment of bursitis, a conservative treatment is usually chosen - in some cases, however, an operative removal of the bursa may be necessary.

What are bursae?

Bursae are flat tissue structures that serve to cushion hard surfaces and soft structures in the body. They contain synovial fluid and thus enable smooth movements. Bursae are usually located near joints, such as the knees, shoulders, or elbows. In addition, they occur in body parts where skin or muscles lie directly on a bone.

Certain occupational groups such as tilers or cleaning ladies, but also wrestlers, hockey and tennis players and hand and volleyball players have an increased risk of bursitis. Because sustained stress - such as constant kneeling while working - are the main cause of bursitis.

Causes of bursitis

Bursitis can be caused by various causes. It is usually triggered by infections, injuries or constant irritation. In addition, osteoarthritis and arthritis, metabolic diseases such as gout and infectious diseases such as tuberculosis or gonorrhea increase the risk of bursitis.

Especially often a bursitis is triggered by a pressure overload. Cause are persistent or recurring movements, as they occur during long-distance running, but also when tiling. Due to the continuous load, the smallest injuries occur, which can lead to inflammation of the bursa.

If an external injury is the cause of a bursitis, a distinction is made between two different forms:

  • External impact such as a knee impact may cause the bursa to fill up with blood and ignite.
  • An open injury near the bursal may allow bacteria to enter the wound and trigger bacterial bursitis.

Typical symptoms of bursitis

With a bursitis initially hardly noticeable symptoms occur - often one notices a burning or slightly rubbing feeling. If the joint continues to be stressed, the symptoms usually increase: It can lead to severe pain (especially pressure), overheating and reddening of the affected area and a significant swelling. This is due to the accumulation of extra fluid in the bursa.

Bursitis is particularly common in joints that are heavily loaded. These include the shoulder, elbow, hip, knee and ankle. If a bursa near a joint is affected, the volume increase may restrict the movement of the joint. Frequently, those affected take a restraint and do not burden the affected joint fully.

In some cases, bursitis may spread to the surrounding tissue, causing redness of the extremities and generalized disease symptoms such as swelling of the lymph nodes, fever, fatigue and fatigue. If the bursa lies deep under the skin, usually only the pain points to an inflammation. Other symptoms are usually absent.

Treat a bursitis

Normally bursitis heals by itself within a few weeks. Until then, acute pain can be treated well with cooling ointments or gels. Also cold packs help to relieve the pain. However, these should not come into direct contact with the skin, otherwise frostbite may occur. Heat treatments should be avoided.

For the bursitis to heal, it is recommended that the affected joint be immobilized by bandage or splint for some time. However, the protection should only be temporary, because if the joint is not moved for too long, it may under certain circumstances lead to persistent restrictions of movement.

Therefore, it is advisable to gently move the joint slowly after a short rest period and without any load. Physicians often prescribe physiotherapy for bursitis so that the joint is first moved under guidance.

Medicines help against pain

To relieve pain associated with bursitis, analgesics such as ibuprofen or diclofenac may be considered. These medications not only reduce pain but also inhibit the inflammatory response. This has a positive effect on the healing process. In case of severe pain, local anesthetics can be injected directly into the respective joint.

If the bursitis is caused by a bacterial infection, an antibiotic can be taken if necessary.

Surgical removal of the bursa

If the inflammation has subsided, but the bursa still felt like a pillow, the accumulated liquid must be removed by means of a puncture. However, surgical removal of the entire bursa is rarely necessary.

An operation is performed, for example, when in chronic bursitis the symptoms do not subside or occur again and again. Chronic bursitis often affects the hips and elbows. In the bursa, intermediate walls of connective tissue can grow and lime deposits occur.

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