Bursitis is caused by inflammation of one or more of the bursa(s) which typically surround and protect certain joints. A bursa is a small fluid-filled sack. The job of a bursa is to cushion and protect by preventing friction between bone and the overlying tendons and muscles.
The goal or function of a bursa is to allow moving muscles to slide smoothly over bone. As a result, activity can intensify the pain associated with an inflamed bursa. Some examples of bursitis include trochanteric bursitis of the hip, pes anserine bursitis of the knee, and subacromial bursitis of the shoulder. Although these can result from injury or trauma, overuse and faulty biomechanics are more often the cause.
Often times patients become discouraged with a diagnosis of bursitis. It is very important for them to understand that it responds very well if managed correctly. When a patient presents with bursitis the first objective is to determine the cause of the pain and discomfort. Muscle imbalances, poor movement patterns, and overuse may all contribute to inflammation of the bursa. Manual therapy techniques are applied to the surrounding tissues rather than the bursa itself, as direct pressure to a bursa can further irritate the area. We expect to see decreased pain after just a few treatments. Corrective exercises are usually prescribed for long-term management of the condition.
While rest may be the most common prescription for bursitis, it may require several weeks or months before relief is felt, and the biomechanics are never corrected. This is why an active approach is recommended.