Bursitis: is an acute or chronic inflammation of the bursa, a sac-like gap in the connective tissue, located mainly between the bony prominence near the joint and the tendon or muscle, and the skin (as shown in the small blue pad in the picture). The bursa can be present wherever there is friction or pressure, and its role is mainly to reduce or avoid friction and pressure between the bony prominences and soft tissues near the joint. (It is a buffer zone of friction between the bones of the joint) Tian Hongtao, Department of Orthopedics, Wuhan Union Medical College Hospital
High-risk groups: adults, especially women, over 40 years of age, obese, legs of unequal length, habitually sedentary, frequent long-term use of joints, such as climbing stairs, running, long-term standing, kneeling workers, often wearing pointed leather shoes, etc.; and people suffering from acute and chronic joint injuries (such as fractures, strain, surgery, etc.), diabetes, gout, rheumatoid arthritis, tuberculous arthritis, joint infections, etc.
Clinical manifestations: Theoretically, bursitis can occur wherever there is a bursa, and its common manifestation is the gradual appearance of a type of round swelling in the joint or bone prominence, which grows slowly with pressure pain. The following is a breakdown of the manifestations of bursitis in each common joint.
Shoulder bursitis: The causes of damage include falls, pushing, and repetitive overhead lifting activities; mainly shoulder discomfort during overhead lifting and extension, increased pain at night, and decreased shoulder flexibility.
Elbow bursitis: the most common cause of elbow bursitis is bursitis of the hawk’s beak, which is mainly caused by repeated bending and straightening of the elbow, such as repeatedly swinging a tennis racket or golf club, pushing and pulling a vacuum cleaner back and forth, etc.; the pain is mainly noticeable when bending the elbow.
knee bursitis: the most common is prepatellar bursitis, also known as workers’ knee, housewife’s knee; when working on the knees for a long time, there may be a touch legal person in the front of the knee, there will be a soft mass, the pain will increase when the knee is bent, climbing stairs and at night, the pain can radiate to the inner thigh and upper calf; acute and chronic joint trauma, osteoarthritis, also often involved in the knee bursa
Bursitis of the hip: sciatic nodal bursitis, which can occur when sitting on hard surfaces for long periods of time, such as bicycling for long periods of time, and in older women who are sedentary; it is mainly characterized by pain in the hip when walking and sitting, localized pain on pressure, and pain that can radiate to the dorsal thigh.
Toe bursitis: mainly due to long-term wearing of pointed and narrow leather shoes or high-heeled shoes, and excessive foot movements, such as skating, etc., which can cause localized pain in the toes, and bunion deformities.
Ankle bursitis: see “Heel pain” for details.
Diagnosis: history and physical examination, X-ray, fluid examination, CT, MRI, etc.
Treatment
1, general treatment: such as post-traumatic icing (at least 2 times a day, at least 10 minutes each time); elevation of the affected area, local pressure, such as the use of elastic bandages at the elbow and knee joints; massage of the affected area, the use of blood-stasis ointment; most of them can subside; when the pain is obvious, non-steroidal anti-inflammatory drugs can be used to relieve symptoms.
2, treatment of primary diseases, such as gout, rheumatoid arthritis, etc.
3, aspiration of intracapsular fluid by puncture, followed by injection of prednisolone acetate and pressure bandaging, which can sometimes be cured.
4. burslectomy can be considered for those for whom non-surgical treatment is ineffective, but there is a possibility of recurrence.
Prevention.
Best prevention to reduce the activity of the corresponding joint, in addition to the use of some protective measures: such as the use of knee pads, wrist guards, put soft cushions, choose comfortable shoes, increase the elasticity and strength of the muscles and do appropriate rehabilitation exercises.
If sciatic nodal bursitis.
Put one foot on a chair or step, keep the knee and back straight, then slowly lean your body forward, hold the posture for 15 seconds when you feel a mild to moderate reduction in hip pain, rest, and repeat 4 times. (Provided that it does not lead to an increase in pain).
Lie down as shown, bend your knee, move your knee towards your shoulder with the help of your hand, hold the posture for 15 seconds when you feel a mild to moderate reduction in hip pain, rest, and repeat 4 times. (Provided that it does not lead to an increase in pain).
See other joint-related diseases, such as “frozen shoulder”.
(Image from the internet)
Author: Tian Hongtao, Wuhan Union Orthopaedic Hospital