Bursitis:
Inflammation of bursa,.
What is Bursa?
Bursa is a fluid filled sac that reduces the friction between two surfaces, such as bone and ligament or tendon and bone.
It is expected to have more than 160 bursas in the human body.
What causes the inflammation of bursa?
Most common cause for bursitis are local trauma (Direct Injury), fall on the joint, overuse injury, sports injury, excessive kneeling, leaning on the elbows for longer period of time while working at a desk.
Other systemic diseases such as RA, SLE and Gout will cause chronic and recurrent bursitis.
Infections are another important cause for the acute and chronic bursitis, can be from haematogenous spread infections from Staphylococcus aureus or other pathogens, most commonly happens due to puncture (transcutaneous) or micro trauma , less commonly due to haematogenous spread which is called as septic bursitis.
Crystalline deposits will cause bursitis in Gout.
Different types of bursitis
Most common type of bursitis is Sub acromion bursitis, which occurs at the shoulder joint, involves supra supinates muscle.
Other types of bursitis are:
- Pre-patellar Bursitis (House maids knee) occurs just above the knee due to the inflammation of patellar bursa.
- Infra-patellar Bursitis (clergyman’s knee) inflammation of one or more infra patellar tendons due to repetitive strain injuries
- Trochanteric Bursitis causes pain on the lateral aspect of hip.
- Olecranon Bursitis (Students Elbow) pain in the posterior aspect of elbow, due to constant kneeling on the joint, also happens in most computer bound sitting jobs.
- Pes Anserine Bursitis happened between skin and patella, most often occurs in Obese people or in severe degenerative arthritis condition. Most of the times the inflammation occurs due to recued subcutaneous fat and increased susceptible for direct injury.
- Pathophysiology: Due to the above-mentioned reasons, there will be increased fluid secretions from synoviocytes or increased inflammation. With the persistent inflammation there will be increase in the inflammatory cytokines, proteases, cyclooxygenases, or sodium or ureate crystals deposits may occur at the site.
Diagnosis:
Predominantly the diagnosis happens clinically by physical examination.
Physical examination may reveals that pain, swelling, local redness, aberrations, contusion, and reduced range of motion.
In septic bursitis is suspected with systemic issues such as fever or altered inflammatory markers, need for arthrocentesis / aspiration for the identification of specific bacteria is warranted most commonly performed in shoulder and knee joints.
Treatment:
Most common treatments include RICE:
- Rest
- Ice application
- Compression
- Elevation
- NSAIDS
- Local Steroid Injections
- Finally surgical correction may include bursectomy.
Bursitis can be treated as generalized inflammation by using some of the treatments such as valuka swedam or lepam or Dhara based on the presentation.
If there is reduction of subcutaneous fat; need for local Dhara treatment will be very effective.
If the Burs is intact with increased inflammation need for upanaha and lepa treatments.
Clinically best treatment for bursitis is valuka swedam., where we use herbs as such as rasandhi with sand- made in in to poultice, warm poultice will be applied gently on the joint for a period of time will give significant changes in pain and inflammation.
Some of the anti-inflammatory herbs such as Turmeric, Boswellia, Moringa and aswgandha and Pippali (Piper Longum) will be useful in reducing some of the symptoms.
For further information please contact your healthcare practitioner or logon to jeevahealth.com.au to consult one of our practitioners based in Melbourne or Canberra.
