The bursa is a fluid-filled sac under the skin, usually over the joints, which acts as a cushioning area around tendons and bones. Bursitis occurs when this covering becomes inflamed. The main symptoms include pain, swelling, tenderness and the joint under the bursa may feel stiff and the surrounding area may be red and warm. The pain is described as a dull ache made worse by movement, with soreness.
Pressure on the area or weight bearing may make it worse. For example, when sleeping, lying on the affected side may cause hip, elbow or heel pain. While any bursa can become inflamed, the most common joints affected are the knee, the elbow, shoulder and hip.
The Causes for Bursitis
When nerves don’t work, lots of small injuries to the body, cause inflammation. Diabetes is associated with a great variety of musculo-skeletal manifestations and their management improves the patients’ quality of life.
These aren’t always clear, but injury or repetitive movement can cause inflammation around a bursa. Triggers such as physical activities that involve a lot of repetitive movement, for example kneeling and rocking back and forwards when gardening or cleaning the floor (hence ’housemaid’s knee’), or playing darts (causing elbow bursitis). Bursitis can also develop in any joint as a result of an infection or as a complication of certain long-standing conditions, such as rheumatoid or other inflammatory arthritis and gout.
See your GP if symptoms don’t settle, you develop a high fever or feel shivery and hot, the pain becomes severe or you can’t move the joint. If your doctor is concerned about infection in the bursa (septic bursitis), or if the symptoms are severe with extensive redness or fever, they may take a fluid sample from the bursa to look for infection or gout crystals, or send you to hospital for this. Blood tests check for inflammatory arthritis and MRI scans look for injury.
Septic bursitis is more common in people with reduced immunity such as those with diabetes, chronic kidney or liver disease, or on steroids or chemotherapy.
Pain killers such as paracetamol help to relieve the pain, while ibuprofen or other non-steroidal anti-inflammatories help reduce swelling. Steroid injections may reduce inflammation, but are never used if septic bursitis is suspected. Instead, antibiotic injections are needed. Rarely, surgery is indicated to drain or remove chronically inflamed bursae. Losing weight certainly helps and if you’ve had bursitis in a joint previously and the symptoms have settled, strengthening the surrounding muscles with gentle exercise will protect from further injury.
- The first goal is to reduce the sugar floating around in your body.
- Rest and elevate the joint, avoid trigger activities and apply ice packs regularly or a bag of frozen vegetables wrapped in a tea towel.
- Use protective devices, such as knee pads when kneeling and at night use cushions to relieve pressure on sore areas. Avoid lying on the affected side.
- Always warm up properly before exercise. If leg joints are affected, avoid long periods standing up. Take regular breaks during tasks involving repetitive movements.
- Vary your patterns at physical activity by carrying out different tasks or exercises that do not involve using the same part of your body.
E359 – Bursitis and Diabetes Pressures – www.diabetic.today