Bursitis is not a very dangerous disease, but it has unpleasant symptoms and often affects ability to work. Its name comes from the Latin word bursa, which translates as “bag,” and the essence is that inflammation develops in the mucous bursa, usually in the joint area. Mucous bags are located next to muscles, joints, bones, and under the skin. They help reduce stress on tissues and prevent their “wear and tear”.
Bursitis can be acute or chronic. Their main reasons:
- Frequent monotonous movements and pressure on joints.
- Injuries.
- Arthritis, including rheumatoid, gouty.
- Infections.
Occupational bursitis is a chronic disease that is caused by the first group of reasons from this list. They are connected, as the name of the pathology suggests, with the characteristics of the profession.
Who gets occupational bursitis?
A person is at increased risk if his joints, due to the nature of his work, experience increased stress:
- Leatherworkers, shoemakers, chasers, polishers, engravers, people who work with computers, do some work with their hands, and often lean on their elbows when sitting at a table (jewelers, watchmakers). As a result, they often develop elbow bursitis.
- The weak point of tilers, parquet floorers, and miners is their knees. These people are often diagnosed with prepatellar bursitis.
- Choppers, shapers and farriers are at increased risk for subdeltoid bursitis, which is when the bursa in the shoulder joint becomes inflamed.
- An occupational disease for loaders is supraclavicular bursitis.
- The disease does not even spare artists, otherwise ballerinas would not have to suffer from Achilles bursitis - inflammation of the bursa in the area of the Achilles tendon, which is located behind the heel bone.
The risk of getting sick increases with age, as the joint “wears out”. Excess body weight contributes to the development of bursitis of the lower extremities.
Causes of the disease
The knee joint, large and mobile, is subject to significant stress and is often injured. Knee injuries are associated with the characteristics of the profession or playing professional sports.
Prepatellar bursitis most often affects:
- movers;
- builders;
- skiers;
- track and field athletes;
- football players, etc.
Where does bursitis occur?
Most often, bursitis occurs in the area of the shoulder, hip, elbow, knee joint, heel, and at the base of the big toe. Typical locations for inflamed synovial bursae are joints, in which a person often makes monotonous movements. Therefore, bursitis is often an occupational disease. Weightlifters and wrestlers often suffer from it. Runners and parkour enthusiasts experience inflammation of the bursae in the ankle and knee joints. People who frequently kneel are at increased risk. Playing darts can lead to elbow bursitis. Sometimes the disease develops as a result of acute trauma.
Bursitis can become a complication of diseases of the joints and connective tissue, such as gout, rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus, systemic scleroderma. Sometimes inflammation is caused by a nonspecific infection that penetrates the synovial bursa through a cut or scratch. Much less common are specific bursitis caused by pathogens of gonorrhea, tuberculosis, brucellosis, and syphilis.
Diagnostics
Diagnosis of bursitis is based on a history (onset of symptoms, nature of knee pain, how symptoms affect their lifestyle, etc.) and a physical examination. In order to exclude a fracture or soft tissue damage, in some cases it is necessary to perform radiography, CT or MRI. If it is not known whether the bursa is infected or not, arthrocentesis can be done. This is usually done for three reasons: (1) to obtain information for diagnosis, (2) to relieve pressure in the joint and relieve pain, (3) to administer medication.
Differential diagnosis
Prepatellar bursitis is often confused with other causes of knee pain, including:
- Damage to the medial collateral ligament.
- Damage to the lateral collateral ligament.
- Osteoarthritis.
- Bursitis of the anserine foot.
- Damage to the posterior cruciate ligament.
- Rheumatoid arthritis.
- Patellar tendon rupture.
- Chondromalacia patella.
- Patellofemoral pain syndrome.
Physical examination
The physical examination includes an assessment for:
- hyperemia of the knee;
- erythema;
- soreness;
- swelling;
- pain;
- range of movements.
When there is limited range of motion or swelling, the doctor may recommend removal of intra-articular fluid. This fluid may be sent to laboratories to determine if the bursa is infected.
Common tests for infection include Gram stain, white blood cell count (increased white blood cell count in synovial fluid indicates inflammation), and glucose level (low glucose levels may also indicate inflammation). Gram staining is used to identify specific pathogens. Not all bacteria can be identified. Even when the test is negative, septic bursitis cannot be completely ruled out.
What are the symptoms of occupational bursitis?
Since occupational bursitis is a chronic disease, its symptoms increase gradually. There are two main manifestations:
- Pain in the joint area, which intensifies during movements and pressing on the joint.
- Skin redness and swelling - this can increase greatly over time.
These symptoms are already a reason to visit a doctor. But alarming signals may arise in which you need to seek medical help immediately: increased body temperature, severe sharp, shooting pain, rapid increase in redness on the skin and swelling, inability to move the joint.
Classification
Knee bursitis is classified into several types. In accordance with the clinical course, the pathology can be: chronic, subacute and acute.
Depending on the pathogen that became the source of the problem, bursitis can be nonspecific and specific (against the background of tuberculosis, gonorrhea, syphilis, brucellosis). In this subgroup, the disease is in turn divided into infectious and aseptic (non-infectious).
Depending on the nature of the liquid contents in the bag, the disease occurs:
- hemorrhagic - exudate contains red blood cells in a significant volume;
- serous - the liquid secretion contains plasma mixed with blood;
- purulent - the liquid contains destroyed leukocytes and cellular tissue, bacteria;
- fibrinous - the exudate contains an increased amount of fibrin.
Why are bursitis dangerous?
Bursitis itself is not dangerous, but an infection can get inside the inflamed bursa - in this case, the bursa turns into an abscess, this leads to increased symptoms and creates the risk of some complications.
Bursitis is diagnosed by a surgeon during an examination. Sometimes the manifestations of inflammation of the synovial bursa are very similar to the symptoms of joint diseases such as osteoarthritis and arthritis. In doubtful cases, an ultrasound and x-ray of the affected joint are prescribed, as well as a puncture, during which a certain amount of fluid is removed and sent for examination to the laboratory.
Rehabilitation period
After the operation, a rehabilitation period begins. You should not think that since the joint capsule has been removed, bursitis will never bother you again. Surgical treatment does not solve all problems. A joint that does not have an articular capsule is very vulnerable and if it is injured, it is unlikely to be able to avoid serious complications.
In the first 72 hours after surgery, it is recommended to reduce the load. You should place a small cushion or pillow under your leg. During the rehabilitation period, massage, electrotherapy, and post-isometric relaxation of spasmed muscles are prescribed. NSAIDs are prescribed to relieve pain. If they fail to cope with their task, then the bursa is aspirated and injections of corticosteroids and analgesics are prescribed.
An important element of the rehabilitation period is exercise therapy. Exercises will help increase joint flexibility and give muscle strength. The doctor selects a set of exercises for each patient individually. Training is carried out strictly under the supervision of a doctor (occupational therapist).
For each patient, the doctor individually selects a set of exercises.
If the doctor’s recommendations are followed, the patient returns to his normal life within 2-3 weeks. In severe cases, the rehabilitation period may take another couple of weeks.
How is bursitis treated?
There are some things you can do for treatment yourself. First of all, you need to eliminate any stress on the affected joint. In the first 48 hours from the onset of symptoms, cold should be applied to the sore spot, then replaced with heat. Pain can be managed with over-the-counter painkillers from the non-steroidal anti-inflammatory drug group, such as ibuprofen.
The doctor can puncture the inflamed bursa - pierce it with a syringe needle and remove excess fluid. After this, apply a pressure bandage. For severe pain, glucocorticosteroids are administered locally - preparations of adrenal hormones that suppress inflammation and pain.
Physiotherapy helps relieve pain and strengthen muscles in the area of the inflamed synovial bursa. Physiotherapy (UHF) is prescribed, when the symptoms subside - therapeutic exercises. If the bunion occurs on the foot, it is recommended to use a cane until the symptoms subside. In rare cases, it is necessary to resort to surgical treatment. A bursectomy is performed - removal of the inflamed bursa.
You will have to stop doing work that causes symptoms of bursitis, at least for a while. It is recommended to follow basic rules: do not put too much or prolonged stress on the joint, use soft knee pads and elbow pads. Timely consultation with a doctor when the first symptoms occur helps keep the joints in working condition.
Folk remedies
Lilac tincture will help relieve inflammation
It is recommended to use remedies from the arsenal of traditional medicine only for non-infectious inflammation of the bursa. Such treatment should be agreed with a doctor.
- Cold compresses quickly eliminate swelling and pain. To do this, it is recommended to take several pieces of ice, wrap them in a towel and apply them to the sore joint for 15 minutes. You can also wet a towel and place it in the freezer for 20 minutes. This towel is then applied to the knee. Cold compresses should be applied 3-4 times a day.
- For bursitis, rubbing Indian onion with alcohol tincture helps a lot. To do this, apply a small amount of tincture to a terry towel and rub your knee along the massage lines.
- For rubbing, you can use a tincture of lilac flowers, which is recommended for inflammation of the joints and periarticular tissues.
- To reduce inflammation, compresses with propolis tincture are used. Gauze must be moistened in the product, applied to the joint for an hour, secured on top with an elastic bandage.
Treatment with folk remedies takes about two weeks. It is worth noting that drug therapy eliminates symptoms in just a few days.
Can bursitis be prevented?
If you are at high risk, here are some guidelines you should follow:
- Use knee pads if your job requires kneeling for long periods of time.
- Do not lift too heavy loads. When possible, it is better to use a cart or other device.
- Lift weights correctly: first you need to squat with your knees bent. Otherwise, your hip joints will be under too much stress.
- Take frequent breaks if you have to perform repetitive movements.
- Maintain a healthy weight.
- Always warm up before starting sports training.
Bursitis is a fairly mild disease that can be successfully treated. But some more serious pathologies may manifest similar symptoms. Visit a surgeon at the ProfMedLab clinic: our specialist will establish an accurate diagnosis and recommend effective treatment.
At the ProfMedLab clinic you can get advice from an experienced medical specialist; we organize medical examinations. Contact us to find out more and take advantage of our services: +7 (495) 120-08-07.
Prevention
There is no specific prevention of the disease. If there are predisposing factors, the development of prepatellar bursitis can be prevented by limiting excessive physical activity, using special knee pads or braces when playing sports. An equally important measure is the timely detection and treatment of traumatic injuries of the knee joint.
Prepatellar bursitis is a treatable disease, but a positive effect can only be achieved with timely diagnosis and timely initiation of therapy. It is important to carry out the course of treatment to the end to prevent the disease from becoming chronic.
Author: Yulia Khaimanova, doctor, especially for Ortopediya.pro
Application of a knee brace
As an additional therapeutic device for bursitis, you can resort to using a new device - a knee brace. It helps stimulate local blood circulation due to the influence of a certain spectrum of radiation.
The device affects the body with rays similar in range to solar radiation. Thanks to this, additional energy is produced, which the body receives and uses for accelerated tissue repair.
Since the device acts locally, the penetration of the energy flow is noted deep into the tissues of the synovial bursa, which accelerates the elimination of toxic substances and stimulates the growth of new tissues, as well as increasing their elasticity.