Bursitis

• A bursa is a small flat sac lined with synovium.
• The two membranous surfaces of the bursa are normally in contact, separated only by a thin film of lubricating fluid.
• A bursa reduces friction, usually between tendons and bones.
• The cause of bursitis is overuse of the structures surrounding the bursa, resulting in excessive friction and inflammation of the bursa walls.
• Bursitis is often secondary to other conditions such as tendonitis.
• Contributing factors include
  • Muscle imbalances
  • Poor biomechanics
  • Postural dysfunctions (scoliosis or kyphosis)
  • Lack of flexibility.
  • Less frequently
    • Acute trauma
    • Infection
    • Osteoarthritis
    • Gout
    • Rheumatoid arthritis

Acute traumatic bursitis frequently occurs in the olecranon, trochanter, ischiatic, prepatellar or calcaneal bursae.

Acute bursitis

• The bursa is compressed and irritated by the surrounding structures.
• Inflammation, heat, and swelling are present.
• The pain is deep and burning, at rest or during activity. It may refer to some distance from the bursa. Pain may disrupt sleep, especially if compressed.
• Range of motion of the affected joint is restricted. Distal or proximal joints may have reduced range of motion if there is a muscle or fascia crossing the affected bursa.
• Other conditions, such as tendonitis, may be present.

Chronic Bursitis

• Pain or soreness is experienced with activity or with direct compression. Pain is more localized to the bursa.
• Chronic inflammation, fibrosis, and adhesions are present.
• The range of motion of the affected joint is less restricted than in the acute stage.