Bursitis is the term used to describe a painful condition where a bursa has become swelled and irritated. A bursa (or bursae) is a small sac of synovial fluid that lies between bone and tendons or soft tissue, which prevents friction between the bone and soft tissue by acting as a cushion.

Did you know there are over 150 bursae in the human body?

When bursitis occurs, a bursa enlarges with fluid and any movement against or direct pressure upon the bursa will precipitate pain for the patient.

Bursitis can occur in any of the bursae that exists in the body; mainly seen in the shoulder, elbow, ankle, knee, hip, and thigh.

What Causes Bursitis?

Prolonged pressure applied to the area of the bursae from a hard structure and bony surface. An example is someone who works on their knees, or a student who leans on their elbows for long period.
Repetitive movements: Some people are more likely to develop bursitis due to repetitive movements or repetitive load on the body. This is common in sports such as baseball, where there is overhead arm activity. Repetitive kneeling, which is common for a carpenter, can develop bursitis in the knee.
Trauma: Bursitis can result from the injury.
Infections: Infectious bursitis can occur, which is known as septic bursitis.
Secondary to other diseases: bursitis can occur in rheumatoid arthritis, tuberculosis, uremia or crystal deposits, such as in gout or pseudogout.

How Is Bursitis Diagnosed?

Your experienced practitioner will diagnosis the bursitis by the information given in the clinical symptoms and the clinical examination. A clinical assessment will look for tenderness on palpation of the bursae, swelling & associated pain on movement and at rest.

It is important to also differentiate bursitis and other conditions that present similarly. In differentiating from other pathologies, further investigation may be required, such as an ultrasound or MRI.

X-ray can be a valuable source to distinguish and exclude fractures, especially avulsion fracture.

What Can A Physiotherapist Do For Bursitis?

Teach you about self-management techniques for symptoms – such as rest, ice, NSAIDs, etc.
Advise you on movements – to prevent further irritation and inflammation of the bursae
Massage – to reduce and offload the tension in the surrounding muscle.
Taping – to support and improve pain-free movement
Exercise prescription – to help improve strength and quality of movements
Referral to GP – if further investigation required

References

Adams G et al. 2013 2ND ED Emergency medicine E Book: Clinical Essential Elesveir and Saunders
Lustenberger DP, Ng VY, Best TM, Ellis TJ. Efficacy of treatment of trochanteric bursitis: a systematic review. Clin J Sport Med. 2011;21(5):447-453. doi:10.1097/JSM.0b013e318221299c
Pangia J, Rizvi TJ. Olecranon Bursitis. [Updated 2019 Feb 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2019 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK470291/
Starr M and Kang H (2001)Recognition and management of common Forms of Tendinitis and Bursitis The Canadian Journal of CME 155 – 163
Williams CH, Sternard BT. Bursitis. [Updated 2020 Apr 24]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2020 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK513340/