Bursae (synovial bursa) are small sacs filled with fluid. They are found wherever there is increased mechanical stress in the body. They are designed to absorb pressure, reduce friction and thus protect tendons, muscles, bones and skin. If these mechanical stresses get out of hand, inflammation occurs.
Bursae can become inflamed in all joints of the body.
Around 160 bursae are responsible for painless movement in the body. For example, bursae can be found in the shoulder joint, the hip or the ankle joint of the foot. Theoretically, all bursae in the body can become inflamed. However, bursitis is particularly common in stressed areas or joints, such as the shoulder, hip, elbow, foot and heel or knee. Bursitis (ICD code: 71.9) is also known as bursitis and can have various causes.
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Bursae protect the tissue of the hip. © bilderzwerg / Fotolia
In many cases, excessive pressure is responsible for the inflammation of the bursa. In particular, recurring and/or persistent activities that exert a pressure stimulus on the bursa can cause inflammation. These activities include, for example, laying tiles or carpets, sitting on hard chairs for long periods or endurance sports such as long-distance running. The pressure irritation causes so-called microtraumatization. These micro-injuries cause an inflammatory reaction in the affected structure.
Larger injuries and traumas, such as those caused by accidents, can also promote the development of bursitis. In the event of an open injury, bacteria can enter the wound and infect the bursa. However, such bacterial bursitis occurs less frequently. Bursitis is more often the result of a blow or a collision. The bursa fills with blood as a result of the accident and becomes inflamed.
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Bursitis in the knee joint: the swelling causes pain. © Henrie / Fotolia
Pathological changes in the joints also irritate the bursa and thus promote inflammation. Diseases such as
osteoarthritis or arthritis as well as the metabolic disorder
gout are therefore more frequently associated with bursitis.
Redness, swelling and overheating of the area around the bursa are typical signs of inflammation and the main symptoms of bursitis. As it is mainly the bursae close to the joint that become inflamed, patients feel pain in the joint. The joints are sensitive to pressure and the pain worsens with movement.
If the inflammation spreads beyond the bursa, the surrounding tissue structures and regional lymph nodes may also swell. Other signs of pronounced and/or bacterial bursitis are
- Fever,
- fatigue,
- fatigue and
- general malaise.
In a detailed medical history interview , the doctor will ask about the specific symptoms. The quality of the pain as well as physical activities, occupation, previous illnesses or accidents are of interest as possible triggers of the inflammation.
Once the symptoms and medical history have been recorded, the doctor will carry out a physical examination . He pays attention to
- Pain-sensitive areas,
- swelling,
- redness and
- overheating.
To assess the extent of the inflammation, he also palpates the lymph nodes.
If the causes of the inflammation remain unclear or if bursitis occurs several times for no apparent reason, further examinations can be carried out. Altered joint and bone structures become visible in an
X-ray examination . A
blood test also helps to identify general diseases such as gout.
First aid: Rest and cold
To prevent further irritation of the inflamed bursa, the affected area of the body is temporarily
immobilized . However, joints should not be immobilized for too long to prevent functional or movement restrictions.
Cooling
ointments, ice packs or cooling pads can alleviate the inflammation and ensure that the swelling subsides. Anti-inflammatory and pain-relieving medication such as ibuprofen can also counteract the symptoms.
Puncture against fluid accumulation
Although simple bursitis can usually be treated well,
fluid accumulation can remain. This appears in the form of a painless swelling. The doctor aspirates the fluid during a puncture using a cannula and then injects anti-inflammatory
cortisone into the bursa. A temporary
pressure bandage is applied to prevent further fluid accumulation.
Bacterial bursitis: surgery and antibiotics
Bacterial bursitis requires special treatment. The doctor must
open the bursa
surgically to remove the purulent fluid in the sac. In addition, patients with a bacterial infection usually have to take an antibiotic. In rare cases, complete surgical removal of the bursa may be necessary.
If the bursitis is caused by another disease, such as osteoarthritis or gout, the treatment depends on the underlying disease. The risk of recurrent bursitis is only reduced if the
underlying disease is treated causally.
The course and duration of bursitis depend on the cause, severity and treatment of the disease. With adequate treatment, uncomplicated bursitis heals within four to six weeks without any consequences.
Consistent rest, taking anti-inflammatory medication and regular cooling and massages can have a positive effect on the healing process and reduce the duration of the disease.
Protection for bursae and joints: balance diet and exercise
You can also do something good for your joints and healthy bursae in everyday life. Make sure you take regular exercise that is adapted to your state of health and does not overload you. At the beginning, let yourself be guided by special types of sport or fitness training to prevent incorrect strain. The bursae and joints also benefit from a healthy body weight within the normal range.
Turmeric and ginger are considered anti-inflammatory foods. Whether fresh or dried, these spices not only enrich your diet, but also have a positive effect on inflammation in the body.
