A bursa is a connective tissue sac filled with fluid. There are bursa in many places in the body. They are often located above tendons, joints or protrusions. Like a cushion, they protect certain parts of the body against pressure and reduce the friction that occurs during movement, e.g. on the elbow or knee joint. Due to an injury, overload or infection, a bursa can swell, hurt and inflammation can develop.
Bursitis often occurs on the elbows, knees, shoulders, hips or around the ankle. However, it can affect almost every joint in the body.
Irritation or inflammation of a bursa can develop due to one or more combined causes. Different forms are distinguished according to the causes.
Typical signs of bursitis are:
Irritation of the bursa is often only shown by pressure pain, without other typical signs of inflammation. The symptoms also depend on the location of the bursa.
Bursitis can occur in different areas of the body. Examples are:
If the bursa is inflamed at the shoulder corner joint (subacromial bursitis), pain in the shoulder can occur, which also radiates into the upper arm and is particularly pronounced. reinforce when lifting the arm. The complaints can also have other causes, e.g. tendinitis or other injuries to the shoulder joint. In sports where the shoulder joints are under a lot of stress, the risk of shoulder bursitis is increased. These include e.g. Badminton, basketball, swimming or volleyball.
The bursa on the elbow is usually significantly swollen in inflammation (bursitis olecrani). Pain occurs when you bend your elbow, but not when you stretch. Bursitis on the elbow can arise from repeated support, but can also have other causes, e.g. Injury, infection of the bursa or other inflammatory disease.
One bursa of the knee is in front of the patella, another under the patella tendon. Inflammation of these bursae (prepatellar bursitis, infrapatellar bursitis) can result from repeated kneeling. Pain is typical in the area of the two bursae, which subside with the knee straight. The bursa under the inner ligament of the knee (medial collateral ligament) can also be affected by painful inflammation, e.g. due to an overload during sport (e.g. running). Possible other causes of the pain are e.g. Knee ligament injury, meniscus injury, infection of the bursa, etc.
A large bursa is located between the hamstring muscle (lat. Muculus iliopsoas) and the hip bone. Inflammation of this bursa (iliopectinic bursitis) can cause pain in the groin area during certain movements, e.g. when climbing stairs. Sometimes a painful snap can be felt in the groin. One possible cause is overwork due to sports, e.g. long running.
Inflammation of the bursa between the heel bone and the attachment of the Achilles tendon (retrocalcaneal bursitis) causes swelling in the heel and pain when walking or touching. The inflammation can be caused by a single or repeated overload, e.g. through long running, walking, dancing or jumping. Another common cause of heel pain is inflammation of the Achilles tendon.
The doctor collects the medical history, asks about symptoms and examines the affected part of the body. Ev. movement tests are carried out. Imaging examinations, e.g. X-rays, ultrasound or MRI are used to clarify a possible injury to the joint or a capsule-ligament injury. Inflammation can be determined by taking a blood sample and taking a laboratory test. In order to check whether there is bacterial inflammation or gout arthrosis, the doctor can remove liquid from the bursa using a sterile puncture.
Treatment is based on the cause of the inflammation and location of the bursa.
For the initial treatment of bursitis, the so-called PECH rule (break, ice, compression, high camp) is helpful, which is mainly used for sports injuries. The measures can also be carried out by laypersons.
In most cases, bursitis is treated conservatively (without surgery). The measures include:
Surgery may be necessary in rare cases. Indications include chronic, aseptic inflammation of the goblet or serious infections that, despite treatment, do not subside even after several weeks. The bursa is removed surgically (bursectomy).