Bursitis

Joint disorders | June 1, 2017 | Author: Naturopath

Inflammation

Bursitis

The bursae are small, fluid filled sacs located usually between skin and a tendon, or bone and a tendon, their purpose being to reduce friction. Multiple bursae are located around shoulder, hips, elbows, knees and feet.

The role of bursa

bursitis bursaBursa help facilitate the movement of tendons over bony surfaces and are located in many areas of the body. Inflammation of the bursa is called bursitis.

How does it happen?

Over- use and infection are the most common causes for inflammation, but it can be caused by a direct fall leading to bleeding into the bursa. This may result in acute traumatic bursitis.

Other possible causes include systemic illness like collagen vascular disease and inflammatory arthropathy (disease of the joint - commonly arthritis); in some instances the cause is unknown.

bursitis kneesCertain occupations are associated with bursitis and are named accordingly; for example ‘housemaid's knee’ is bursitis of the prepatellar (the front of the knee), and ‘clergyman's knee’ is the name given for superficial infrapatella bursitis (located just below the kneecap).

Diagnosis

Diagnosis is usually determined by the presence of tenderness, swelling in the localized area and pain on movement.

How to help

Bursitis may be hard to treat due to poor blood supply to the bursae site. Conventional treatment would usually involve non-steroidal anti-inflammatory drugs which may be ineffective and aspiration of the fluid maybe necessary.

Go to the cause

Osteoarthritis (OA) is one of the most prevalent and disabling chronic diseases affecting usually the older population. OA involves the wearing out of articular cartilage, inflammation of synovial membrane, bone degradation and destruction of joint tissue.

bursitis knee painOveruse injury can be the result of any repetitive activity causing micro trauma overload and the inability of the tissue to repair itself. This can lead to an inflammatory response, to acute and then possible chronic inflammation - resulting in structural changes.This can occur during sport or day-to-day activities.

The cause may be obvious or evident immediately after evaluation by a professional. 

Obvious causes may include; an increase or change in activity, a change in surroundings/equipment, poor foot wear; biomechanical changes - malalignment, lack of flexibility, muscle imbalance or weakness; inadequate nutrition.
Treatment of overuse injury usually involves rest (avoiding the aggravating activity), the use of ice, T.E.N.S. machine, soft tissue massage and the use of non-steroidal medication (NSAIDs).

Infected bursitis occurs when a bursa is not only inflamed but also infected.

A bursa may become infected when a bacteria or microorganism enters the bursa through a cut, scrape, puncture, insect bite or other means. It is possible to have septic bursitis without an obvious entry point on the skin and the origin of the infection is unknown.

A compromised immune system or poor circulation may lead people to be more susceptible to developing septic bursitis. For example, people with cancer, HIV/AIDS, chronic obstructive pulmonary disease (COPD), lupus, alcoholism, or diabetes may have compromised immune systems. Certain medication can contribute to lowered immunity or poor circulation.

In addition to the typical symptoms of bursitis, such as local pain and/or swelling at a joint, there are specific indicators that the bursa may be infected.

bursitis infectionThe main symptoms of an infection include:

  • Extreme warmth and redness of the skin at the joint
  • Acute tenderness of the bursa
  • Fever or chills and generally feeling sick

Septic bursitis is a potentially serious medical condition and prompt medical attention is advisable. Long term antibiotic therapy is usually required.

Natural therapies

The application of ice, compression and rest is usually a good start. Check footwear is offering enough support and replace if needed.

Diet should include foods to help reduce inflammation and induce repair. These include whole grains, fruits, vegetables, and fatty fish. iInclude nuts (walnuts) and seeds (linseeds, chia seeds). Avoid processed foods and foods high in sugar and fat.
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Supplements that may help to reduce pain and inflammation

Glucosamine sulfate. Glucosamine is a substance found in cartilage, the tissue that covers the ends of bones in a joint. Some evidence suggests it may help treat the pain of osteoarthritis. It may also help reduce inflammation in bursitis.
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bursitis inflammationFish oil (omega 3) has been found to reduce the inflammatory response and thereby may reduce joint pain and inflammation.
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Bromelain is an enzyme derived from the core of pineapples and has been found to reduce inflammation.There is preliminary clinical evidence to support the contention that the anti-inflammatory and analgesic properties of bromelain help to reduce symptoms of osteo- and rheumatoid arthritis.

Bromelain may be effective in reducing physical symptoms and improving general well-being in otherwise healthy adults suffering from mild knee pain taken as needed.
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Boswellia (Boswellia serrate). A Cochrane systematic review concluded that preparations from BS “show trends of benefits” (when used for the treatment of OA) coupled with minimal side effects. Citing two high-quality and two moderate-quality studies demonstrating superiority compared to placebo in reducing pain and increasing functionality

bursitis turmericTurmeric (Curcuma longa) a combination of Curcuma longa and Boswellia serrata has been shown to be more efficient than a standard dose of a selective COX-2 inhibitor in the treatment of osteoarthritis. A recent meta-analysis found enough evidence for the use of turmeric as a therapeutic option in arthritis.

Devils claw (Harpagophytum procubens) - the roots of this native Africa herb have anti-inflammatory, analgesic and anti-rheumatic actions. It has been approved by commission E for use for musculoskeletal degenerative problems.

White willow (Salix alba) has anti-inflammatory, analgesic and anti-rheumatic properties and is suggested for any systemic connective tissue disorders marked by inflammation - arthritis/rheumatism and muscular problems - making it an ideal herb for use with bursitis. It has been approved by commission E as an anti-rheumatic agent.

bursitisGinger A study found a highly purified and standardized ginger extract had a statistically significant effect on reducing symptoms of OA of the knee. This effect was moderate.

Arnica (arnica montana) - is a well-recognised anti-inflammatory and has been a medicine in many countries in Europe as a topical rub for joint/muscle inflammation strains and sprains.
Topical use only

 

Some supplements may not be appropriate or interact with medications. If you are pregnant or breastfeeding, talk to your doctor before adding a supplement to your regimen.
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References:

Brukner P, Khan K, 1993, Clinical Sports Medicine, McGraw-Hill Book Company Aust

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3354353/ Bursae around the knee joints

https://www.arthritis-health.com/types/bursitis/septic-bursitis

http://www.umm.edu/health/medical/altmed/condition/bursitis

Fisher, C; (2009), Materia Medica of Western Herbs, New Zealand

https://www.ncbi.nlm.nih.gov/pubmed/12587686 Bromelain reduces mild acute knee pain and improves well-being in a dose-dependent fashion in an open study of otherwise healthy adults.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5295114/ Phytomedicine in Joint Disorders

https://www.ncbi.nlm.nih.gov/pubmed/16531187 Omega-3 fatty acids (fish oil) as an anti-inflammatory: an alternative to nonsteroidal anti-inflammatory drugs for discogenic pain.

https://www.ncbi.nlm.nih.gov/pubmed/11710709 Effects of a ginger extract on knee pain in patients with osteoarthritis.

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