Our latest blog discusses all things Bursa….enjoy!
A bursa is a fluid-filled sac normally found throughout the body at points of mechanical friction or pressure. Bursae (in Latin an ‘e’ is placed on the end to denote a plural term) are therefore found around mobile joints and around moving structures such as tendons and bones. Examples include: the tip of elbow, the lower end of the Achilles tendon, the shoulder rotator cuff tendons, and the knee.
The knee alone has approximately 11 bursae at locations including above the knee cap (suprapatellar bursa); in front of the knee cap (pre-patella bursa); and below the knee cap (infrapatellar bursa).
Diagram of the Knee joint showing small sacs of fluid (bursa) found around the joint to improve movement and reduce friction. (Image credit: smart.servier.com)
For the vast majority of the time these fluid sacs work without fault, tirelessly lubricating and cushioning the moving musculoskeletal system. Occasionally, however, they may develop an issue, usually in the form of friction or impact. In such cases, the bursa becomes inflamed and swollen; and we refer to this as a ‘bursitis’.
**Sometimes a bursa may become inflamed and swollen due to a local infection. This type of bursitis is associated with redness and heat. If you develop these symptoms seek a professional healthcare opinion as soon as you are able to. **
The location of a bursa often predisposes it to specific stresses. For example, the pre-patella bursa of the knee (mentioned earlier) is vulnerable to pressure when kneeling on all-fours. For this reason prepatellar bursitis has historically been referred to as ‘housemaids knee’, because it may have been seen frequently in those kneeling to complete manual cleaning duties. Many of these terms are outdated now, but you may still hear and read terms such as ‘students’ elbow’ and ‘goalkeepers’ elbow’ to denote repeated friction and traumatic pressure at the olecranon bursa respectively. ‘Weaver’s bottom’ may still be found as a label for ischial (or ischiogluteal) bursitis – a painful condition found in a buttock from sitting for a prolonged time on a firm surface. (This would have taken its name from the textile production methods that are now largely redundant.) Despite their dated origins these commonly used terms might still help us picture the cause of an inflamed bursa and, therefore might help with understanding the activity modification that is required to promote recovery.
If you have bursitis (that is not due to a local infection, as emphasised earlier) then you may benefit from some expert advice, such as a Chartered Physiotherapist.
Here at Great Northern Physiotherapy we can help by providing a thorough clinical examination to help exclude other rarer causes of bursitis, such as gout or rheumatoid arthritis. We can also provide a treatment plan to reduce the symptoms or address the underlying cause of the bursitis. These might include taping, a tailored exercise programme, and in some cases shockwave therapy (NICE interventional procedure guidance 376). Moreover, local steroid injections can also help reduce the swelling of bursitis, and these are offered under ultrasound guidance at Great Northern Physiotherapy.
You can also take simple self-help measures to reduce the pain and inflammation caused by bursitis:
- Reducing the pressure / causative factor.
- Applying ice packs (or a bag of frozen vegetables) wrapped in a damp tea towel to the area for up to 10 minutes at a time, every 2-3 hours.
- Use padding, such as a thick foam cushion or knee pads, to reduce pressure when kneeling.
- Wear footwear that is comfortable and properly fitted, or purchasing protective insoles, may relieve the pressure on inflamed bursae in your feet.
- Medication: Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen could help relieve the pain of bursitis. These can be used in the form of an oral medicine (tablet / capsule) or as a topical gel applied directly to the area. Please consult a pharmacist before taking any new medicine that you are unsure of.
If you feel you may need help from a painful Bursa contact us at 01522 787164 or book online.
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