Bursae are fatty pads found all over the body, wherever muscle or ligament runs close to bone. Their job is to prevent friction between the bone and soft tissue. However, they can become irritated themselves: this is bursitis.
Symptoms of Bursitis
The “-itis” in the name highlights the inflammatory nature of the condition. When there is inflammation, symptoms can be worse with rest or excessive activity, causing stiffness in the morning and after significant exercise. A cool compress can help to take the edge off, while heat can exacerbate things further.
Some bursae can become surprisingly enlarged when inflamed. “Student’s Elbow” is the colloquial name for bursitis on the tip of the elbow, where you might rest it on a desk. The bursa here is close to the surface, and can swell to the size of an egg. Despite the dramatic appearance, the swelling is often totally painless, although this is not true in all cases.
Mechanical causes are often to blame, but occasionally the cause is bacterial, in which case it is labelled septic bursitis. If your symptoms coincide with fever or generally feeling unwell, you may be best off speaking to your GP before seeing your osteopath. Antibiotics may be required.
Common Areas for Bursitis
As mentioned above, bursitis can affect the elbow when there is repetitive or extended pressure to the area. The legs are also common areas for bursitis: the illustration above shows some locations of bursae in the knee. Some familiar terms for inflamed bursae around the knee are:
- Housemaids knee (behind the knee cap)
- Clergymans knee (below the knee cap)
Baker’s cysts can present similarly, causing swelling in the back of the knee. However, this is unlikely to be related to a bursa, and is more typically an out-pouching of joint fluid from the main knee joint.
Beyond the knee, bursae can become inflamed around the pelvis, including over sitting bones or around the hip joints. They can also affect the heel and front of the shoulder.
Because bursae are present between any soft tissue and bone, there are countless numbers of them throughout the body. The most commonly affected ones are the most well known, but even in the knee alone there will be more than shown above.
Relation to Other Areas
The trochanteric bursa illustrated above is located on the outside of the hip. Bursitis here often occurs in association with a knee problem. If the knee is unstable, the iliotibial band (ITB) on the outside of the thigh can become taught in an attempt to stabilise it. This tension is controlled by the TFL muscle, which runs over the bursa before blending into the fibrous ITB. The tension in the soft tissues can cause excessive pressure and friction on the trochanteric bursa, leading to bursitis. Although local treatment can help to make the area more comfortable, the root cause may be the knee. Your osteopath will look for other areas that might be associated with your bursitis in order to manage the whole problem.
