That dull misery in the shoulder, knee or elbow known as bursitis can strike anybody, from the couch potato to the highly trained athlete. Though bursitis may hurt as much as arthritis, it isn?t a
joint disease. Rather, it's an acute or chronic painful inflammation of a bursa. Bursae (from the Greek word for wine-skin and related to the English word purse) are small, closed, fluid-filled sacs
that protect muscles and tendons from irritation produced by contact with bones. If friction becomes too great, from overexercising, hard work, or injury, for instance-the bursae themselves may get
inflamed. Though the shoulder is a common locale for bursitis, any of the bursae in the human body-there are approximately 150-can become irritated. Occupational bursitis is not uncommon and is known
by old, familiar names such as "housemaid's knee," and "policeman's heel." One of the most common foot ailments, the bunion, is a form of bursitis.
Overtraining in a runner (eg, excessive increases in miles or intensity). Tight or poorly fitting shoes that, because of a restrictive heel counter, exert excessive pressure on the posterior heel and
Haglund deformity, causing impingement between the increased posterior superior calcaneal prominence and the Achilles tendon during dorsiflexion. More recent research suggests that a misaligned
subtalar joint axis (measured in terms of joint inclination and deviation) in relation to the Achilles tendon can result in an asymmetrical force load on the tendon, disrupting normal biomechanics.
This altered joint axis is associated with an increased risk for Achilles pathologies, including bursitis.
Where the tendon joins the calcaneal bone, friction can cause the spaces between the tendon, bone and skin to swell and inflame with bursitis. This constitutes a calcaneal bursa. Apart from swelling
over the back of the heel, you?ll feel acute tenderness and pain when you move it or even apply light pressure. Your swollen heel may look more red than the other one, and the swelling is often so
hard it can feel like bone, partly because it sometimes is, as a bony overgrowth can occur in chronic cases.
If heel pain has not responded to home treatment, X-rays may be ordered. These images can show deformities of the heel bone and bone spurs that have developed at the attachment of the Achilles. If
there is swelling and/or pain that is slightly higher and within the Achilles tendon itself, an MRI may be ordered to determine if the tendon is simply inflamed or if there is a chronic tear on the
tendon. Aspiration and lab tests. If a septic bursitis is highly suspected, a doctor may perform an aspiration, removing fluid from the bursa with a needle and syringe. In addition to relieving
pressure and making the patient more comfortable, it provides a fluid sample that can be tested for infection.
Non Surgical Treatment
Home treatment is often enough to reduce pain and let the bursa heal. Your doctor may suggest physical therapy to strengthen the muscles around your joints. Rest the affected area. Avoid any activity
or direct pressure that may cause pain. Apply ice or cold packs as soon as you notice pain in your muscles or near a joint. Apply ice 10 to 15 minutes at a time, as often as twice an hour, for 3 days
(72 hours). You can try heat, or alternating heat and ice, after the first 72 hours. Use pain relievers. Use nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or naproxen, to reduce
pain and inflammation. NSAIDs come in pills and also in a cream that you rub over the sore area. Acetaminophen (such as Tylenol) can also help with pain. Don't rely on medicine to relieve pain so
that you can keep overusing the joint. Do range-of-motion exercises each day. If your bursitis is in or near a joint, gently move the joint through its full range of motion, even during the time that
you are resting the joint area. This will prevent stiffness. As the pain goes away, add other exercises to strengthen the muscles around your joint. Avoid tobacco smoke.Smoking delays wound and
tissue healing. If you have severe bursitis, your doctor may use a needle to remove extra fluid from the bursa. You might wear a pressure bandage on the area. Your doctor may also give you a shot of
medicine to reduce swelling. Some people need surgery to drain or remove the bursa. Sometimes the fluid in the bursa can get infected. If this happens, you may need antibiotics. Bursitis is likely to
improve in a few days or weeks if you rest and treat the affected area. But it may return if you don't stretch and strengthen the muscles around the joint and change the way you do some
Because many soft tissue conditions are caused by overuse, the best treatment is prevention. It is important to avoid or modify the activities that cause problems. Underlying conditions such as leg
length differences, improper position or poor technique in sports or work must be corrected. Be aware of potential overuse or injury in your daily activities and change your lifestyle to prevent
problems. Otherwise, problems may persist or occur repeatedly. Following are some ways you can avoid future problems. Wear walking or jogging shoes that provide good support. High-top shoes provide
support for people with ankle problems. Wear comfortable shoes that fit properly. Wear heel cups or other shoe inserts as recommended by your doctor. Exercise on level, graded surfaces.