Bursitis- What is it?
Our bodies contain many bursae (150 +) which are usually found between bony surfaces and overlying tendons (1). A bursa is a small fluid-filled sac that acts as a cushion between bone and soft tissue (muscles, tendons and skin). Their role is to facilitate the movement of the tendons over the bony surface. A bursa reduces friction and assists joint movement.
Bursitis is inflammation of a bursa. When you overuse or injure a joint, a nearby bursa can become irritated or inflamed. The bursa fills with excess fluid, causing significant pain and restricting movement
What causes Bursitis?
Injury, repeated pressure and overuse are common causes of bursitis. Some conditions, such as rheumatoid arthritis, gout and diabetes, can also contribute to its development. Poor biomechanics, muscle weakness, tightness, movement patterns or postural habits can also contribute to bursitis (1).
Common sites for bursitis include the shoulder (subacromial bursa), hip (trochanteric bursa), knee (prepatellar bursa), elbow (olecranon bursa), Achilles tendon (retrocalcaneal bursa) and foot.
Bursitis pain may settle within a few weeks with the appropriate bursa treatment and may include:
–Acupuncture/dry needling (4)
–Shockwave therapy (2,3,5)
–Soft tissue techniques
–Identification of poor biomechanics
–Exercises and Rehabilitation
Treatment using the above techniques plus identification and correction of poor movement patterns are used here at Tweed Coast Chiropractic.
Bursitis is often a secondary symptom caused by many other factors. The best form of bursitis treatment is to identify, and then address, any abnormal biomechanical of muscle control findings, to reduce your likelihood of a bursitis recurrence.
Two of the most common types of bursitis:
Shoulder bursitis (subacromial bursitis) is common in overhead activities at work or in sport eg swimming, throwing, surfing, paddling, cricket bowling, waterpolo. It is more prevalent in people with poor posture eg round shoulders, weak scapular muscles, thigh pectorals or poor technique.
Hip bursitis (Trochanteric bursitis) sufferers usually have weak hip/gluteal muscles and tend to sway sideways (or collapse) as they walk, which irritates the trochanteric bursa (5). The long-term solution is to address the weak gluteal muscles rather than solely focus on the bursitis itself.
In some rare cases where the above conservative treatment has been ineffective some people may need to consider corticosteroid/anaesthetic injections (6). Secondly, the cause may be disease related. If this is the case, please consult your doctor.
1.Brukner P, Karim K (2012). Clinical Sports Medicine 4th Ed. McGrath-Hill Education. ISBN:9780070998131.
2. Ogden JA, Tóth-Kischkat A, Schultheiss R. Principles of shock wave therapy. Clin Orthop. 2001;387:8–17.
3.Ching-Jen Wang. Extracorporeal shock wave therapy in muscoculosketal disorders. J Orthop Surg Res. 2012; 7: 11.
4.Guerra de Hoyos JA, del Crmen M, Martin A et al. Randomised trial of long term effect of acupuncture for shoulder pain. Pain. 2004;112:3 pgs 289-298
5. Furia JP, Rompe JD, Maffulli N (2009). Low energy extracorpeal shock wave therapy as a treatment for greater trochanteric pain syndrome. Am J Sports Med: 37(9):1806-13
6. Sayegh ET, Strach RJ. (2014). Treatment of olecranon bursitis: a systemic review. Arch Orthop Trauma Surg. 134(11):1517-36