Bursitis, Bursitis

2023 Author: Wallace Forman | [email protected]. Last modified: 2023-05-24 12:25

Bursitis

A bursa is a bag of connective tissue filled with fluid. There are bursae in many places in the body. They are often found over tendons, joints or protruding bones. Like a cushion, they protect certain parts of the body from pressure and reduce the friction that occurs during movement, for example on the elbow or knee joint. An injury, overuse, or infection can cause a bursa to swell, hurt, and inflammation may develop.

Bursitis (bursitis) often occurs on the elbows, knees, shoulders, hips or around the ankle. However, it can affect almost any joint in the body.

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• What are the causes of bursitis?
• What are the symptoms?
• Where can bursitis occur?
• How is the diagnosis made?
• How is bursitis treated?
• Whom can I ask?
• How are the costs going to be covered?

What are the causes of bursitis?

Irritation or inflammation of a bursa can develop from a single cause or from several combined causes. Different forms are distinguished according to the causes.

• Acute injury or overloading of the bursa, e.g. from a fall, blow (acute, aseptic bursitis).
• Chronic overload due to frequent, strong pressure or friction on the bursa, e.g. from kneeling for a long time or leaning on the elbow (chronic, aseptic bursitis).
• Infection, e.g. caused by bacteria that get into the bursa through small, superficial skin injuries (septic bursitis).
• Inflammatory diseases, e.g. rheumatoid arthritis, gout.

What are the symptoms?

Typical signs of bursitis are:

• Swelling caused by an increased build-up of fluid in the bursa
• Pain, especially when pressing the bursa or moving the joint,
• Restrictions on the mobility of the joint,
• Reddening of the skin, noticeable warmth in the area of the bursa,
• A fever and rapid development of inflammation can also be signs of an infection of the bursa.

Often, irritation of the bursa shows only pressure pain, without other typical signs of inflammation. Symptoms also depend on the location of the bursa.

Where can bursitis occur?

Bursitis can occur in different areas of the body. Examples are:

Bursitis shoulder

With an inflammation of the bursa on the shoulder joint (bursitis subacromialis) pain in the shoulder can occur, which also radiates into the upper arm and is especially pronounced when the arm is raised. The symptoms can also have other causes, such as tendinitis or other injuries to the shoulder joint. When doing sports that put a lot of stress on the shoulder joints, the risk of bursitis of the shoulder is increased. These include badminton, basketball, swimming or volleyball.

Bursitis elbow

The bursa on the elbow is usually significantly swollen when there is inflammation (bursitis olecrani). Pain occurs when bending the elbow, but not when stretching. Bursitis on the elbow can result from repeated propping up, but it can also have other causes, e.g. injury, infection of the bursa or another inflammatory disease.

Bursitis knee

One bursa of the knee is in front of the kneecap (patella), and another is under the patellar tendon. Inflammation of these bursa (prepatellar bursitis, infrapatellar bursitis) can result from repeated kneeling. Typical are pain in the area of the two bursae, which subside with the knee extended. The bursa under the inner ligament of the knee (medial collateral ligament) can also be affected by a painful inflammation, e.g. due to excessive strain during sports (e.g. running). Other possible causes of the pain are, e.g. knee ligament injury, meniscus injury, infection of the bursa, etc.

Bursitis hip

A large bursa is located between the hip flexor muscle (Latin: Muculus iliopsoas) and the hip bone. Inflammation of this bursa (iliopectineal bursitis) can cause pain in the groin area during certain movements, e.g. when climbing stairs. Sometimes a painful snap can be felt in the groin. One possible cause is overwork through exercise, e.g. long running.

Bursitis heel

Inflammation of the bursa between the heel bone and the attachment of the Achilles tendon (bursitis retrocalcanea) causes swelling of the heel and pain when walking or touching it. The inflammation can be caused by one-time or repeated overuse, such as running, walking, dancing, or jumping for a long time. Another common cause of heel pain is inflammation of the Achilles tendon.

How is the diagnosis made?

The doctor collects the medical history, asks about complaints and examines the affected part of the body. Ev. movement tests are carried out. Imaging examinations, such as X-rays, ultrasound or MRI, are used to clarify a possible injury to the joint or a capsule ligament injury. The presence of inflammation can be determined by taking a blood sample and laboratory examination. To check whether there is a bacterial inflammation or gout osteoarthritis, the doctor can use a sterile puncture to remove fluid from the bursa.

How is bursitis treated?

Treatment depends on the cause of the inflammation and the location of the bursa.

For the initial treatment of bursitis called PECH-rule (P housing, E is, C ompression, H ochlagern) helpful, which is mainly used for sports injuries. The measures can also be carried out by laypeople. For more information, see: Emergency: Injuries

Treatment without surgery

In most cases, bursitis is treated conservatively (without surgery). The measures include:

• Immobilization (pause): It is important to immobilize and protect the affected bursa or joint so that the inflammation can subside. The bursa is to be protected from stress (sports break), pressure or impacts. The doctor explains to the patient which measures and means are helpful for this, e.g. avoiding certain movements or overloading, using cushioning insoles in shoes, adapting work equipment, etc.
• Cooling (ice): Repeated cooling can relieve the pain, especially in the case of superficial bursitis, for example on the elbow, outer knee or heel. Cool packs or ice should always be wrapped in a cloth and must never be placed directly on the skin in order to avoid skin damage.
• Warmth may be helpful for deeper inflammations, e.g. hip, inner knee or shoulder. The doctor can inform the patient about the exact application of the cold or heat treatment.
• Compression: A compression bandage with an elastic bandage can prevent further swelling and also immobilizes the joint.
• Elevation: If a knee or foot is affected, repeated elevation can help reduce swelling.
• Medication: To treat pain, the doctor prescribes anti-inflammatory medication, usually so-called non-steroidal anti-inflammatory drugs (NSAIDs). A bacterial infection of a bursa (septic bursitis) is treated with antibiotics.
• Glucocorticoid injection: In the case of certain aseptic bursitis, especially if other conservative therapies do not bring any improvement, the doctor can suggest the injection of a long-acting glucocorticoid (cortisone), possibly in combination with a pain reliever. The agents have anti-inflammatory and analgesic effects. The injection is usually used for inflammation of deeper-lying bursa of the shoulder, hip or knee. In the case of superficial forms, the injection of glucocorticoids is usually not helpful, e.g. for olecranon bursitis on the elbow, retrocalcanic bursitis on the heel or prepatellar bursitis on the knee.
• Puncture: In the case of severely swollen, painful bursae, the doctor can suggest puncturing the bursa. The doctor takes liquid from the bursa using a hollow needle to reduce the swelling. Usually, however, the liquid forms again. With a puncture, there is a risk of bacteria getting into the bursa. A puncture can also be performed to clarify an existing infection.

Treatment with surgery

In rare cases, surgery may be necessary. The indications include chronic, aseptic bursitis or severe infections which, despite treatment, do not subside even after several weeks. The bursa is surgically removed (bursectomy).

Whom can I ask?

If you suspect bursitis, you can contact the following offices for diagnosis and treatment:

• General practitioner
• Specialist in orthopedics and traumatology
• Specialist in orthopedics and orthopedic surgery

An inpatient stay in the hospital is necessary for surgical treatment.

How are the costs going to be covered?

The e-card is your personal key to the benefits of the statutory health insurance. All necessary and appropriate diagnostic and therapeutic measures are taken over by your responsible social insurance agency. A deductible or contribution to costs may apply for certain services. You can obtain detailed information from your social security agency. Further information can also be found at:

• Right to treatment
• Visit to the doctor: costs and deductibles
• What does the hospital stay cost?
• Prescription fee: This is how drug costs are covered
• Medical aids & aids
• Health Professions AZ

and via the online guide to reimbursement of social insurance costs.