Bursitis is defined as an inflammation of the bursa.  Bursa is a small synovial fluid filled sac made of connective tissue.    This bursa sac acts as a cushion to reduce friction and increase glide when bones, tendons and ligaments move over other soft tissue and joints.  This protective cushion works to create smooth, uninhibited movement.    If bursae were not present tendons would fray and rupture with repeated movement over bony prominences. 

Bursae are found in all joints but most commonly in the shoulder, knee, hip, elbow, wrist and heel of the foot.  When the bursa is irritated, the bursa cells increase creating an excess amount of synovial fluid leading to inflammation and pain. 

Common causes of Bursitis are:

• Overuse – repeating the same activity over and over
• Sports related injury or direct trauma
• Infection from abrasions or penetrating injuries
• Rheumatoid arthritis
• Thyroid Disease
• Diabetes
• Bone spurs or calcium deposits
• Gait imbalance due to hip or leg length differences

Various locations of bursitis Symptoms of Bursitis:

• Swelling
• Redness, usually near a joint, with superficial bursitis
• Pain with movement
• Limited range of motion
• Fever and malaise if from an infected bursae

How does Bursitis get diagnosed?

Visit your health care practitioner.  They should consider any other local injuries you may have including any presence of arthritis.  They may remove a sample of fluid from your bursa using a needle or syringe to determine whether there is an infection.  You may also receive X-rays and blood tests.  MRI’s are usually only performed if the doctor feels there may be other issues in the local area. 

Treating Bursitis:

• Non-steroidal anti- inflammatories to reduce swelling 
• Warm, moist applications 
• Compression wrap around any affected joints
• Modification of any overuse activities that may be creating the bursitis
• Removal of synovial fluid via needle or syringe
• Cortico-steroids

Be sure to seek the help of a health care professional when treating bursitis.  It may be symptomatic of other issues listed above

Massage treatment for Bursitis:

In the initial acute inflammatory stage of bursitis, massage on the affected area should be avoided.  However, massaging the compensating muscle groups is beneficial in taking stress off the joints.  In particular, the University of Maryland Medical Center has found myofascial release to be especially helpful in relieving pain from bursitis.  The above link also has excellent alternative therapy options and offers an explanation of the role improved nutrition can play in treating bursitis.

Preventing the return of Bursitis:

Once the swelling has died down consider a strength and exercise routine, preferably one an experienced physical therapist or athletic trainer has recommended.  Additionally, all activities involving repetitive motions for hours at a time should be carefully monitored, adjusted and decreased.  If bursitis occurred because of a gait imbalance be sure to see a podiatrist for orthotic insoles.  John Hopkins offers some helpful tips on prevention here.

About the author:

Naomi Gonzalez is a nationally certified licensed massage practitioner specializing in sports and injury therapy and founder of Inspire Your Body Massage.  A former Olympic therapist for the 2004 US Women's National Soccer Team, Naomi brings over 10 years experience working with athletes at all levels of training and discipline.

References:

1.  http://orthoinfo.aaos.org/topic.cfm?topic=a00409

2.  http://www.med.umich.edu/1libr/aha/aha_bursitis_crs.htm

3.  http://www.umm.edu/altmed/articles/bursitis-000022.htm

4.http://www.johnshopkinshealthalerts.com/alerts/arthritis/JohnsHopkinsHealthAlertsArthritis_908-1.html?type=pf

5.  Anderson, Hall, Martin, Sports Injury Management; 1^st Ed 1995; 442-3

6.  Werner, Ruth, A Massage Therapist's Guide to Pathology; 4th Ed 2008